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The Accessibility Guide describe the universal tools, designated (Wisconsin)

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The Accessibility Guide describe the universal tools, designated
supports, and accommodations available for the Wisconsin Forward
Exam.
Any accommodation not in The Accessibility Guide must be approved
by DPI prior to use during the Forward Exam. DPI staff will determine
whether the requested accommodation impacts the validity of the test
results and/or the construct the test is intended to measure.
INSTRUCTIONS:
Please submit requests for accommodation review at least
two weeks prior to the start of the testing. Questions may
be directed to (608) 267-1072.
1. Download and save the form to your device.
2. Complete the form electronically and save.
3. Email saved form to DPI’s Office of Educational
Accountability at osamail@dpi.wi.gov.
GENERAL INFORMATION
Date of Request: Grade Level of Student:
District: School:
Staff Contact Person: Telephone:
E-mail Address: Fax:
PROPOSED ACCOMMODATION
Proposed Accommodation for Student:
Without a disability With a disability on a 504 plan
With a disability on an IEP English Learner (level 1-5)
Content Area(s) Using Proposed Accommodation:
ELA Mathematics Science Social Studies
Description of requested accommodation not included in The Accessibility Guide (Please be specific regarding the
description of what the accommodation is and how this student will use this particular accommodation in order to access
the assessment.):
Wisconsin Forward Exam
Request for Accommodation
Ext.
Rationale for this accommodation (Please be specific regarding why this student needs this particular accommodation
in order to access the assessment.):
DPI DECISION – For DPI Use Only
Approved for use with the Forward Exam. This accommodation does not affect test validity
Approved for use with the Forward Exam with the following conditions:
Not Approved for use with the Forward Exam. This accommodation affects test validity. If the school chooses to
use this non-standard accommodation, the test must be invalidated. The student will count as a non-participant
for accountability purposes and no score will be received for those content areas where the accommodation is in
use.
Reason:
DPI Authorized Signature: Date:
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Completed 29 March 2021

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