Grades 1-12

This waiver request application is for school districts seeking to administer the ACCESS for ELLs assessment using the paper mode in Grades 1-12 in school year 2022-2023. This form is not required for:

Kindergarten test administrations
Alternate ACCESS test administrations
Allowing handwriting on paper for the Writing domain
Providing ACCESS testing accommodations required by a student’s IEP

Please ensure that all fields are completed in order to facilitate the processing of your request. The “Submit” button will activate once the form is complete. Please note: District/school staff will need to demonstrate a deficiency in testing hardware or available bandwidth to receive a waiver.

Step 1: Provide General Information

Contact First Name:

Contact Last Name:

Contact Role:

Contact Phone:

Contact Email:

District Lookup. (Enter all or part of the District Name or the RCDTS Code. Click the search button to find your district.)

Please wait while we look up that information.

No district can be found. Please check "My district isn't listed" below.

My district isn't listed:

Please provide the name of your district:

Select the name of your school. (If your school is not listed, please check "My school isn't listed" below.)

Please wait while we look up that information.

My school isn't listed:

Please provide the name of your school:

Step 2: Provide Technology Information

Total Number of Student Devices in the District:

Desktops:

Laptops:

Chromebooks:

Tablets:

Internet Service Provider:

Type of Connection:

Other/Additional Details:

Total Network Bandwidth:

Resources

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Grades 1-12

Step 1: Provide General Information

Step 2: Provide Technology Information

Step 3: Provide Additional Information and Submit

Contact Information

Resources

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​Grades 1-1​2

Step 1: Provide General Information

Step 2: Provide Technology Information

Step 3: Provide Additional Information and Submit

Contact Information

Grades 1-12