2016-17 Test Impropriety Initial Report Form

District Test Coordinators (DTCs) must use this form to report all potential test improprieties to the Oregon Department of Education. DTCs must submit their initial report within one day of learning of the potential test impropriety. For more information on filling out this form, visit http://oregon.gov/ode/educator-resources/assessment/Pages/Assessment-Training-Materials.aspx.


















(if more than one, write "See Attached" and upload an Excel spreadsheet with all impacted tests. See "Multiple Tests Impacted" below.)






(if more than one, write "See Attached" and upload an Excel spreadsheet with all impacted tests. See "Multiple Tests Impacted" below.)


(if multiple tests were impacted, please upload an Excel spreadsheet containing the SSID, Student Enrolled Grade, Test Name, and Result ID for all impacted tests using the Multiple Tests Information Upload Template located at http://oregon.gov/ode/educator-resources/assessment/Documents/multiple_tests_information_upload_template.xlsx)



















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