Grades 1-12

This waiver request application is for school districts that desire to administer the ACCESS for ELLs on paper in grades 1-12, in school year 2021. This form is not required for paper test administrations at Kindergarten, to provide accommodations that require a paper mode administration to student with IEPs, to allow handwriting on paper for the Writing domain, or to administer the Alternate ACCESS. Please, ensure that all fields are completed in order facilitate the processing of your request. The submit button will activate after completing the form. Please note, to receive a waiver, district/school staff will need to demonstrate a deficiency in hardware or available bandwidth.

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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

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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

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Step 1: Provide General Information

Step 2: Provide Technology Information

Step 3: Provide Additional Information and Submit

Contact Information

Grades 1-12