District Assessment Coordinator
Agreement to Maintain Confidentiality
INSTRUCTIONS: The confidentiality form must be completed by the designated district assessment
coordinator each school year. All other confidentiality forms completed within your district will be
retained at the school/district level.
1. Download and s
ave the form to your device.
2. Review each confidentiality agreement.
3. Ensure you have selected the appropriate responses at the end of the ACT High
School Assessments Confidentiality form.
4. Complete the signature page electronically and save.
5. Email signed form to DPI’s Office of Educational Accountability at osamail@dpi.wi.gov
.
District Assessment Coordinator
Confidentiality Agreement
WISCONSIN FORWARD EXAM
AGREEMENT TO MAINTAIN CONFIDENTIALITY
T
he Wisconsin Forward Exam is a secure, proprietary test instrument with components
copyrighted by DRC. Any disclosure of test items to any person might constitute a copyright
violation. Also, any such disclosure or dissemination of test items will undermine the value of the
test and adversely affect the validity of test results. The confidentiality of test questions and
answers is paramount in maintaining the integrity and validity of the test. Accordingly, the
Department of Public Instruction and Wisconsin educators must take every step to assure the
security of these test instruments.
I hereby agree that I will not disclose to any person, any materials (such as, but not limited to: test
items, graphics, tasks, scoring rubrics, item specifications, test design, content limits, and
measurement/research/report data) related to the Wisconsin Forward Exam.
I acknowledge that I will have access to a secure assessment in the Wisconsin Forward Exam. I
also acknowledge that I have read, understand, and agree to adhere to the Appropriate Testing
Practices (available in the Test Security Manual) and the Wisconsin Forward Exam Test Security
Policies. I understand that these testing materials are secure, and it is my professional responsibility
to protect their security. I agree to complete each assessment’s required training. I therefore pledge:
1.
I have read and understood the Test Security Manual and the Accessibility Guide.
2.
I will read the Test Administration Manual, use the testing resources available on the
Wisconsin Forward Exam webpage and follow the appropriate testing procedures.
3.
I will follow the procedures in the DRC INSIGHT Portal Guide.
4.
I will train appropriate district staff and school assessment coordinators on test
administration and test security procedures.
5.
I will not keep, copy, reproduce, paraphrase, distribute, or discuss any test materials and/or
test items.
6.
I will not use test items or any of the information contained in the assessment to
review/prepare students for a test.
7.
I will not allow any unauthorized person to access the test materials.
8.
I will not alter students’ responses in any manner (indicate answers, point out rationale,
prompt, etc.).
9.
I will not disclose individual student test scores or test performance data to unauthorized
persons.
10.
I will monitor test administrators/proctors and students to ensure that only references or
tools specifically designated in test manuals or by accommodations are provided.
11.
I understand that if a breach of test security or copyright infringement occurs as a direct
result of my actions, and breach of contract, consequences may include invalidation of
student test results, civil legal liability for copyright violations, and district level disciplinary
action.
12.
I understand the importance of student privacy and ensure that any reference to WISE IDs is
kept secure.
District Assessment Coordinator
Confidentiality Agreement
THE ACT HIGH SCHOOL ASSESSMENTS
AGREEMENT TO MAINTAIN CONFIDENTIALITY
The ACT Assessment and the ACT Aspire Assessment, collectively the ACT High School Assessments, are
secure, proprietary test instruments with components copyrighted by the ACT Inc. Any disclosure of test
items to any person might constitute a copyright violation. Also, any such disclosure or dissemination of test
items will undermine the value of the test and adversely affect the validity of test results. The confidentiality
of test questions and answers is paramount in maintaining the integrity and validity of the test. Accordingly,
the Department of Public Instruction (DPI) and Wisconsin educators must take every step to ensure the
security of these test instruments. For that reason, DPI is requiring all Test Coordinators complete this
Agreement.
I hereby agree that I will not disclose - to any person - any materials (such as, but not limited to test
items, graphs, tasks, scoring rubrics, item specifications, test design, content limits, and/or
measurement/research/report data) related to the ACT High School Assessments.
I acknowledge that I will have access to either the ACT Assessment, the Aspire Assessment, or both. I
acknowledge that I have been provided access to Appropriate Testing Practices, available in the Test
Security Manual, and the ACT High School Assessment Test Security Policies, available in the Test Security
sections of the ACT Test Administration Manuals, ACT Aspire Test Coordinator Manual, and the ACT Aspire
Room Supervisor Manual. I understand that all testing materials are secure, and it is my professional
responsibility to protect their security. I therefore specifically pledge:
The ACT Assessment
1.
I will attend required training for the ACT Assessment.
2.
I have read and understood the Test Security Manual and the Accessibility Support Guides for the
ACT.
3.
I will: read the ACT Test Administration Manuals; use the ACT assessment testing resources; and
follow the appropriate ACT testing procedures.
4.
I have read and understood the ACT Prohibited Behaviors at the Test Center and the ACT
Calculator Policy.
5.
I will train appropriate staff and coordinators on test administration and test security procedures.
6.
I will not keep, copy, reproduce, paraphrase, distribute, or discuss any test materials and/or test items.
7.
I will not use test items or any of the information contained in the assessment to review/prepare
s
tudents for a test.
8.
I will check testing rooms prior to the beginning of test administration to ensure that no
specific information is displayed in the room during the test administration.
9.
I will not allow any unauthorized person to access the test materials.
10.
I will not alter students responses in any manner (indicate answers, point out rationale, prompt, etc.).
11.
I will not disclose individual student test scores or test performance data to unauthorized persons.
12.
I will monitor test administrators/proctors/room supervisors and students to ensure that only
references or tools specifically designated in the test manuals or by accommodations are provided.
13.
I understand that if a breach of test security or copyright infringement occurs as a direct result of my
actions, that this will constitute a breach of this Agreement and consequences may include but ar
e
n
ot limited to invalidation of student test results, civil legal liability for copyright violations, and district-
level disciplinary action.
14.
I understand the importance of student privacy and will ensure that any reference to WISE IDs is kept
secure.
15.
I do not have a relative taking the ACT in the state of Wisconsin during this assessment year. “Relative”
means children, stepchildren, grandchildren, nieces, nephews, siblings, in-laws, spouses, and persons
under your guardianship.
16.
I understand the prohibition on athletic coaches serving as test coordinators and affirm I do not serve as
a coach for any high school or college athletics.
The ACT Aspire Assessment
1.
I will attend required training for the ACT Aspire Assessment.
2.
I have read and understood the Test Security Manual and the Accessibility Support Guides for the
ACT Aspire Assessment.
3.
I will: read the Wisconsin ACT Aspire Test Coordinator Manual and Wisconsin Aspire Room
Supervisor Manuals; use the Aspire assessment testing resources; and follow the appropriate Aspire
testing procedures.
4.
I have read and understood the ACT Prohibited Behaviors at the Test Center and the ACT
Calculator Policy.
5.
I will train appropriate staff and coordinators on test administration and test security procedures.
6.
I will not keep, copy, reproduce, paraphrase, distribute, or discuss any test materials and/or test items.
7.
I will not use test items or any of the information contained in the assessment to review/prepare
s
tudents for a test.
8.
I will check testing rooms prior to the beginning of test administration to ensure that no
specific information is displayed in the room during the test administration.
9.
I will not allow any unauthorized person to access the test materials.
10.
I will not alter students responses in any manner (indicate answers, point out rationale, prompt, etc.).
11.
I will not disclose individual student test scores or test performance data to unauthorized persons.
12.
I will monitor test administrators/proctors/room supervisors and students to ensure that only
references or tools specifically designated in the test manuals or by accommodations are provided.
13.
I understand that if a breach of test security or copyright infringement occurs as a direct result of my
actions, that this will constitute a breach of this Agreement and consequences may include but ar
e
n
ot limited to invalidation of student test results; civil legal liability for copyright violations; and district-
level disciplinary action.
14.
I understand the importance of student privacy and will ensure that any reference to WISE IDs is kept
secure.
15.
I will not be a room supervisor/proctor for any relative taking the 9
th
or 10
th
grade ACT Aspire
Assessment. “Relative” means children, stepchildren, grandchildren, nieces, nephews, siblings, in-laws,
spouses, and persons under your guardianship.
Access to test materials: Select one box per assessment.
T
he ACT Aspire Assessment:
I
acknowledge I will have access to test materials for ACT Aspire Assessment and will adhere to all
policies.
T
he ACT Assessment:
I acknowledge I will have access to test materials for the ACT Assessment and will adhere to all policies.
I
acknowledge I will not have access to test materials for the ACT Assessment as I have a relative taking
the ACT Assessment at a school within Wisconsin this administration year. As such, I have delegated
ACT test coordinator responsibilities to another qualified colleague in my district.
District Assessment Coordinator
Confidentiality Agreement
DYNAMIC LEARNING MAPS (DLM)
AGREEMENT TO MAINTAIN CONFIDENTIALITY
The Dynamic Learning Maps (DLM) assessment is a secure, proprietary test instrument with
components copyrighted by Kansas University. Any disclosure of test items to any person might
constitute a copyright violation. Also, any such disclosure or dissemination of test items will
undermine the value of the test and adversely affect the validity of test results. The confidentiality
of test questions and answers is paramount in maintaining the integrity and validity of the test.
Accordingly, the Department of Public Instruction and Wisconsin educators must take every step
to assure the security of these test instruments.
I hereby agree that I will not disclose to any person, any materials (such as, but not limited to: test
items, graphics, tasks, scoring rubrics, item specifications, test design, content limits, and
measurement/research/report data) related to the Dynamic Learning Maps assessment at grades
3-11.
I acknowledge that I will have access to a secure assessment in Dynamic Learning Maps. I also
acknowledge that I have read, understand, and agree to adhere to both the Wisconsin and the
Dynamic Learning Maps Test Security Policies. I understand that these testing materials are
secure, and it is my professional responsibility to protect their security. I agree to complete each
assessment’s required training. I therefore pledge:
1.
I have read and understood the Test Security Manual and the Accessibility Guidelines.
2.
I will read the District Test Coordinator Manual, Test Administration Manual, use the
testing resources available on the Dynamic Learning Maps webpage and follow t
he
appr
opriate testing procedures
3.
I will follow the procedures in the Data Steward Manual and DLM Test Administration Manual.
4.
I will train appropriate district staff and school assessment coordinators on test
administration and test security procedures.
5.
I will not keep, copy, reproduce, paraphrase, distribute, or discuss any test materials and/or
test items.
6.
I will not use test items or any of the information contained in the assessment to
r
eview/prepare students for a test.
7.
I will not allow any unauthorized person to access the test materials.
8.
I will not alter students’ responses in any manner (indicate answers, point out rationale,
prompt, etc.).
9.
I will not disclose individual student test scores or test performance data to unauthorized
persons.
10.
I will monitor test administrators/proctors and students to ensure that only references or
tools specifically designated in test manuals or by accommodations are provided.
11.
I understand that if a breach of test security or copyright infringement occurs as a direct
result of my actions, and breach of contract, consequences may include invalidation of
student test results, civil legal liability for copyright violations, and district level
disciplinary action.
12.
I understand the importance of student privacy and ensure that any reference to WISE IDs is
kept secure.
District Assessment Coordinator
Confidentiality Agreement
WIDA ACCESS FOR ELLs
AGREEMENT TO MAINTAIN CONFIDENTIALITY
T
he WIDA ACCESS for ELLs is a secure, proprietary suite of test instruments with components
copyrighted by The Board of Regents of the University of Wisconsin System and DRC. Any
disclosure of test items to any person might constitute a copyright violation. Also, any such
disclosure or dissemination of test items will undermine the value of the test and adversely affect
the validity of test results. The confidentiality of test questions and answers is paramount in
maintaining the integrity and validity of the test. Accordingly, the Department of Public Instruction
and Wisconsin educators must take every step to assure the security of these test instruments.
I
hereby agree that I will not disclose to any person, any materials (such as, but not limited to: test
items, graphics, tasks, scoring rubrics, item specifications, test design, content limits, and
measurement/research/report data) related to the WIDA ACCESS for ELLs.
I acknowledge that I will have access to a secure assessment in the WIDA ACCESS for ELLs. I
also acknowledge that I have read, understand, and agree to adhere to the Appropriate Testing
Practices (available in the Test Security Manual) and the WIDA ACCESS for ELLs Test Security
Policies. I understand that these testing materials are secure, and it is my professional
responsibility to protect their security. I agree to complete each assessment’s required training. I
therefore pledge:
1.
I have read and understood the Test Security Manual and the Accessibility and
Accommodations Supplement.
2.
I will read the Test Administration Manual, use the testing resources available on the
ACCESS for ELLs webpage and follow the appropriate testing procedures.
3.
I will follow the procedures in the WIDA AMS User Guide.
4.
I will train appropriate district staff and school assessment coordinators on test
administration and test security procedures.
5.
I will not keep, copy, reproduce, paraphrase, distribute, or discuss any test materials and/or
test items.
6.
I will not use test items or any of the information contained in the assessment to
r
eview/prepare students for a test.
7.
I will not allow any unauthorized person to access the test materials.
8.
I will not alter students’ responses in any manner (indicate answers, point out rationale,
prompt, etc.).
9.
I will not disclose individual student test scores or test performance data to unauthorized
persons.
10.
I will monitor test administrators/proctors and students to ensure that only references or
tools specifically designated in test manuals or by accommodations are provided.
11.
I understand that if a breach of test security or copyright infringement occurs as a direct
result of my actions, and breach of contract, consequences may include invalidation of
student test results, civil legal liability for copyright violations, and district level disciplinary
action.
12.
I understand the importance of student privacy and ensure that any reference to WISE IDs is
kept secure.
District Assessment Coordinator
Agreem
ent to Maintain Confidentiality
Signature Page
INSTRUCTIONS REVIEW: The Agreement to Maintain Confidentiality form must be completed by the
designated district assessment coordinator each school year. All other confidentiality forms
completed within your district will be retained at the school/district level.
1. Download and save the form to your device.
2. Review each confidentiality agreement.
3. Ensure you have selected the appropriate responses at the end of the ACT High
School Assessments Confidentiality form.
4. Complete the signature page electronically and save.
5. Email signed form to DPI’s Office of Educational Accountability at osamail@dpi.wi.gov
By si
gning below, I agree that I have read and understand the terms and conditions of each confidentiality
agreement contained within this document. I understand that the terms of each agreement apply
independent of one another, and I agree to be bound by the terms and conditions of each agreement.
Signature
Date
Name
District (and School if appropriate) Name
.
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signature
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