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District, State and National Assessments 2007-2008 Edition California English Language Development Test (CELDT) 2007-2008 Administration Instructions LAUSD Testing Notebook Los Angeles Unified School District Planning, Assessment and Research Student Testing Unit

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Page 1: California English Language Development Test (CELDT)...• Initial Identification of English learners • Annual Assessment of English learners ... Language Development Test 2007-2008

District, State andNational Assessments

2007-2008 Edition California English Language Development Test

(CELDT)

2007-2008 Administration Instructions

LAUSD Testing Notebook

Los Angeles Unified School District Planning, Assessment and Research

Student Testing Unit

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2007-2008 Edition

California English Language Development Test SECTION CONTENTS

Section Contents ………………………………………………………………. ……………….. 1 Fact Sheet ……………………………………………………………………………................. 2 Critical Dates

Annual ……………………………………………………………………………………….. 3 Initial ………………………………………………………………………………………….. 4

Administration Instructions

Major Changes ………………………………………………………………………………. 7 Important Reminders ……………………………………………………………………….. 8 Pre-Kindergarten and Primary Language Assessments ………………………………... 8 Required Test ………………………………………………………………………………... 9 Students to be Tested With Annual CELDT …………………………………………….. 9 Students to be Tested With Initial CELDT ……………………………………………….. 11 Materials Needed ……………………………………………………………………………. 12 Tests to Administer ………………………………………………………………………….. 12 Preparing for Test Administration …………………………………………………………. 13 Preparing Scannable Test Books and Answer Booklets……………………………….. . 15 Completing Answer Booklets With Barcode Labels ……………………………………... 15 Completing Answer Booklets Without Barcode Labels …………………………………. 16 Scoring Initial CELDT Documents – ONLY FOR INITIAL ........................................... 20 Determining Interim Language Classification and Entering Classification in SIS ……. 22 Maintaining Records of Students Requiring Make-Up Testing ………………………… 23 Completing GIS Sheet ……………………………………………………………………… 23 Completing School/Group List …………………………………………………………….. 23 Packing Scorable Documents ……………………………………………………………… 24 Handling Unused Materials ………………………………………………………………… 25 Related Resources …………………………………………………………………………. 25 Assistance …………………………………………………………………………………… 25

Attachments and Forms Returned Testing Materials Verification …………………………………………………... 27 Sample Group Information Sheet …………………………………………………………. 28 Sample School /Group List ………………………………………………………………… 29 Primary Language and Primary Disability Type …………………………………………. 30 Sample Answer Document-Front Cover ………………………………………………….. 31 Sample Answer Document-Inside Front Cover ………………………………………….. 32 Test Record of Students Requiring Make-Up Testing …………………………………... 33 Test Security Agreement …………………………………………………………………… 34 Test Security Affidavit ………………………………………………………………………. 35 Test Administration Procedures …………………………………………………………… 36 Request for Additional CELDT Materials …………………………………………………. 40

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FACT SHEET California English Language Development Test

(CELDT) Students Tested

State Requirement • Initial Identification of English learners • Annual Assessment of English learners • Reclassification of English learners

Students Excluded from Testing Students may not be exempted from testing. Program Requirements and Test Description Senate Bill 638 (Alpert, Chapter 678/1999) requires school districts to assess all English learners (ELs) to determine each student’s individual English proficiency level in Listening, Speaking, Reading, and Writing. The test assesses Listening, Speaking, Reading and Writing skills using performance-based and multiple-choice formats. Scores are reported by proficiency level for each skill area and an overall score. Students are assessed upon entry into a California school, if they meet specific criteria. The assessment must be administered within 30 calendar days of enrollment. Students identified as ELs must be assessed annually until they are reclassified. State Required Tests

• CELDT Listening and Speaking (Grades K-12) • CELDT Reading and Writing (Grades 2-12)

Web Address http://www.cde.ca.gov/ta/tg/el/ www.ctb.com/celdt

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LOS ANGELES UNIFIED SCHOOL DISTRICT Planning, Assessment and Research

ANNUAL CELDT CRITICAL DATES

SINGLE TRACK SCHOOLS

Track Testing Dates Delivery of Testing Materials

*Information Due in SIS

Delivery of Barcode Labels

Due to Testing Center Interim Final

1 Track Sept 5 - Oct 19 August 20 - 24 September 12, 2007 October 10 - 12 Oct 19***

THREE-TRACK SCHOOLS

Track Testing Dates Delivery of Testing Materials

*Information Due in SIS

Delivery of Barcode Labels

Due to Testing Center Interim Final

A-Track Aug 29 - Oct 19 June 18 - 22 September 7, 2007 October 3 - 5 Oct 19***

B-Track ES, MS July 2 - Aug 17 HS July 2 - Aug 24 June 18- 22 July 13, 2007 August 13 - 17 Aug 28***

C-Track July 2 - Oct 19 June 18 - 22 July 13, 2007 August 13 - 17 Aug 28** Oct 19***

FOUR-TRACK SCHOOLS

Track Testing Dates Delivery of Testing Materials

*Information Due in SIS

Delivery of Barcode Labels

Due to Testing Center Interim Final

A-Track Aug 23 - Oct 19 June 18 - 22 August 31, 2007 October 3 - 5 Oct 19***

B-Track July 5 - Sept 21 June 18 - 22 July 13, 2007 August 10 - 16 Aug 28** Sept 27***

C-Track July 5 - Aug 17; Oct 1 - Oct 19 June 18 - 22 July 13, 2007 August 10 - 16 Aug 28** Oct 19***

D-Track July 5 - Oct 19 June 18 - 22 July 13, 2007 August 10 - 16 Aug 28** Oct 19***

* Barcode labels will be printed for new kindergarten students and new students in grades 1-12 who are enrolled in SIS

with complete information prior to these dates. ** Interim turn-in for tests completed by this date. *** Final date for submitting Annual CELDT for the track.

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LOS ANGELES UNIFIED SCHOOL DISTRICT Planning, Assessment and Research

INITIAL CELDT CRITICAL DATES

SINGLE TRACK SCHOOLS

Track Testing Dates Delivery of Testing Materials

*Information Due in SIS

Delivery of Barcode Labels

1 Track September 5 - June 13 August 20 - 24 September 12, 2007 October 10 - 12 THREE-TRACK SCHOOLS

Track Testing Dates Delivery of Testing Materials

*Information Due in SIS

Delivery of Barcode Labels

A-Track August 29 - June 13 June 18 - 22 September 7, 2007 October 3 - 5 B-Track July 2 - June 13 June 18 - 22 July 13, 2007 August 13 - 17 C-Track July 2 - April 11 June 18 - 22 July 13, 2007 August 13 - 17 FOUR-TRACK SCHOOLS

Track Testing Dates Delivery of Testing Materials

*Information Due in SIS

Delivery of Barcode Labels

A-Track August 23 - June 13 June 18 - 22 August 31, 2007 October 3 - 5

B-Track July 5 - June 13 June 18 - 22 July 13, 2007 August 10 - 16

C-Track July 5 - June 13 June 18 - 22 July 13, 2007 August 10 - 16

D-Track July 5 - May 9 June 18 - 22 July 13, 2007 August 10 - 16

*Barcode labels will also be printed for new kindergarten students and new students in grades 1-12 who are

enrolled in SIS with complete information prior to these dates.

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LOS ANGELES UNIFIED SCHOOL DISTRICT Planning, Assessment and Research

INITIAL CELDT CRITICAL DATES

FOR ALL CALENDARS GRADES K-12

Month Due to Testing Center

July 2007 July 13, 2007 August 2007 August 10, 2007

September 2007 September 14, 2007 October 2007 October 12, 2007

November 2007 November 9, 2007 December 2007 December 14, 2007 January 2008 January 11, 2008

February 2008 February 8, 2008 March 2008 March 14, 2008 April 2008 April 11, 2008 May 2008 May 9, 2008 June 2008 June 13, 2008

• Initial CELDT are due to the Testing Center on the second Friday of each month. • Return scorable materials by 3:00 p.m. on dates indicated.

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ADMINISTRATION INSTRUCTIONS 2007-2008 ANNUAL & INITIAL

California English Language Development Test

Major Changes: These instructions should be used in conjunction with the California English Language Development Test 2007-2008 Edition, Version G Examiner’s Manual and the California English Language Development Test 2007-2008 Edition, Versions G1-G11 Scoring Guide. The following are the major changes for 2007-2008 school year: 1. CELDT Form F is obsolete and cannot be used. See Memorandum 3712,

Final Administration of CELDT Form F and Collection of Obsolete Materials, dated May 29, 2007, for instructions on returning the Form F materials.

2. An updated Version G CELDT training video and training audio will be used.

3. CELDT Version G will be used from July 2, 2007 through June 13, 2008. There are eleven forms of Version G: Versions G1, G2, G3, G4, G5, G6, G7, G8, G9, G10 or G11. Some schools will be assigned two different test versions.

4. The Examiner’s Manual can be used to administer all Versions of G1-G11.

5. For grades K-2 there are two new sub-tests that have been added to all versions of the test. In the Listening section, Rhyming is now operational. In the Speaking section, Speech Functions is also an operational test.

6. In the Listening section, for Rhyming, there are two operational test items worth one (1) point each, for a total of two (2) possible points. Versions G2 and G3 have field test items that are not to be scored.

7. In the Speaking section, for Speech Functions, there are two operational items worth two (2) points each for a total of four (4) possible points. Versions G4 and G5 have field test items that are not to be scored.

8. There are new fields on the student data information grid. 9. For hand-bubbled answer documents Box 14, Previous CELDT Scale

Score, should be left blank for all grades and versions. 10. The primary language for Kurdish also includes Kurdi and Kumanji. See

Attachment D for an accurate list of Primary Languages. 11. There are new disability codes for CELDT. In addition, the Disability

Code of 281 “Established Medical Disability” (EMD) is no longer used. See Attachment D for an accurate list of Primary Disability Type.

12. Revised scoring rubrics for Writing Sentences and Writing Short Compositions will be used.

13. Version G results will be scored on the Common Scale established in 2006-2007.

14. The LAUSD Online CELDT Calculator is no longer available. 15. CTB McGraw-Hill e-Tip CELDT Calculator is available for scoring. See

page 20 of this document for instructions.

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16. The instructions for determining interim language classification and entering classification in the Student Information System (SIS) can be found on pages 22 and 23 of this document

17. Each pupil’s CELDT records shall be transferred to the requesting district/school within 20 calendar days (CCR, Title 5, Section 11512). Schools are responsible for providing CELDT results of students that transferred.

Important Reminders:

1. Only trained qualified certificated staff members (teacher credential) must administer the CELDT.

2. Substitute teachers may administer or proctor the test only if they have

signed a security affidavit and attended a 2007-2008 Edition CELDT Training session.

3. Paraeducators are permitted to proctor and assist in the administration of

CELDT (e.g., distribute test materials), but are not permitted to administer the assessment to students.

4. Annual Assessment test documents not submitted for scoring in a timely

manner will be out of compliance with federal and state requirements. 5. No parent waivers are available for CELDT based on federal and state

accountability requirements.

PRE-K and Primary Language Assessments:

The Preschool Language Assessment and Parent Interview Instrument for 3 to 5 year olds will continue to be used to classify new enrollees in the Special Education Infant and Preschool Support Services. These students are reassessed in kindergarten with the Initial CELDT to determine official kindergarten initial identification and classification of a potential EL student. The English PRE-LAS will continue to be used to classify new enrollees in pre-kindergarten who have a home language other than English. The English PRE-LAS results will provide students in pre-kindergarten with an interim classification until they enter kindergarten and are formally assessed using the Initial CELDT. Pre-kindergarten students entering kindergarten and previously assessed with English PRE-LAS must be administered the Initial CELDT in kindergarten. The District will continue to use Spanish PRE-LAS/LAS in pre-kindergarten through grade 12 to assess the primary language of Spanish-speaking ELs. The Basic Inventory of Natural Language (BINL) and Informal Assessment of Home Language Literacy will continue to be used in grades K-12 to assess the primary language of ELs in languages other than Spanish. This will be the last year that the English and Spanish PRE-LAS/LAS will be used by the District.

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Required Tests: The CELDT has four components: 1. Listening (Grades K-12, except where noted)

Listening Section

Kindergarten Grade 1 Grade 2 Grades 3-12

Following Oral Directions

Individually Individually Individually Group

Teacher Talk

Individually Individually or Small Group

Individually or Small Group

Group

Extended Listening Comp.

Individually Individually or Small Group

Individually or Small Group

Group

Rhyming

Individually Individually Individually N/A

2. Speaking (Grades K-12)

Individually Administered • Oral Vocabulary • Speech Functions • Choose and Give Reasons • 4-Picture Narrative

3. Reading (Grades 2-12)

Group Administered • Word Analysis • Fluency and Vocabulary • Reading Comprehension • Literary Analysis, grades 3-12

4. Writing (Grades 2-12)

Group Administered • Grammar and Structure • Sentences • Short Compositions

Students to be Tested with the ANNUAL CELDT:

ANNUAL CELDT ONLY

Continuing ELs are to be assessed with the Annual CELDT

• All currently identified ELs enrolled in grades 1-12 and retained

kindergarteners must be tested with the Annual CELDT. There are no provisions for parent exemptions.

• Retained students are to be tested with the level test for their enrolled grade.

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Annual CELDT results from other districts

• Students with 2007-2008 Annual CELDT results from other districts should not be tested again. CELDT Testing Coordinators should contact the previous school to determine if transferring students have been assessed with the 2007-2008 CELDT. Send a copy of the CELDT result label or Student Proficiency Level Report to the School Information Branch, Beaudry Building, 21st Floor, Attention: CELDT Processing Center, or fax to (213) 241-8969.

• The School Information Branch will enter the scores into the CELDT

master file and download it into the school’s SIS. Duplicate CELDT result labels are not available.

• CELDT results indicating the student’s proficiency in English should

be recorded on the student’s Annual CELDT Cumulative Card Insert. Print the school name and district name where the CELDT was administered and the student’s English Proficiency Level. Initial and date the entry.

Special Education ELs are to be assessed with the Annual CELDT

• Special Education ELs are required to take the CELDT.

Accommodations and modifications must be provided as indicated in section J, No. 3 in the student's IEP. No out-of-level testing is permitted with the CELDT. Students must be administered the level corresponding to their grade assignment. EL students assessed with Version G while enrolled at a previous school are not to be reassessed with the Annual CELDT.

Low and Non-Verbal Special Education Students

• Low and non-verbal special education students who cannot respond

to the CELDT questions must have booklets (K-2) or scannable answer books (3-12) returned as scorable materials. In Box 22 “Test Variations,” “Alternate Assessment” must be bubbled. Attach a barcode label or complete the demographic information if labels are not provided.

• See the “Accommodations and Modifications” section in the LAUSD

Testing Notebook for information about accommodations and/or modifications and page 13 of this document for alternate assessments information.

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Students to be Tested with the INITIAL CELDT:

INITIAL CELDT ONLY

Newly enrolled students in grades K-12 are to be assessed if:

• the response to any of the first three questions on the Home

Language Survey (HLS) is a language other than English • ALL the conditions listed below are true, the student must be

assessed with the CELDT 1. Response to each of the first three questions on the HLS is

English, and 2. Response to question number four is other than English, and 3. There is reasonable doubt as to the student’s proficiency in

English. The following indicators may be used when determining reasonable doubt fluency:

• Parent/guardians need interpreters • Parent/guardians speak to their children in the primary language • Students initiate interaction with their parents/guardians in the primary

language • Parent/guardians hesitate unduly in responding to the first three

questions of the HLS • It is revealed that children, while their parent/guardians are at work,

are under the care of persons who speak a language other than English

• Students, after having been enrolled in the Mainstream English Program designed for students with fluent-English proficiency for a reasonable length of time (30 days or less), demonstrate a lack of comprehension regarding instruction and classroom/school routines.

If, however, there is evidence of a significant non-English background (e.g., the pupil lived with non-English speaking grandmother for a substantial period of time) then the pupil must undergo the CELDT and other appropriate formal and informal assessments. Previously assessed ELs are not to be tested with the Initial CELDT.

• New enrollees with CELDT results from other California public school districts should not be tested again for Initial Identification. CELDT Testing Coordinators should contact the previous school to determine if transferring students have been assessed with the 2007-2008 CELDT. Send a copy of the CELDT result label or Student Proficiency Level Report to the School Information Branch, Beaudry Building, 21st Floor, Attention: CELDT Processing Center, or fax to (213) 241-8969.

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• The School Information Branch will enter the scores into the CELDT master file and download it into the school’s SIS. Duplicate CELDT result labels are not available.

• If CELDT results from a previous school are available, the results

indicating the student’s proficiency in English should be recorded on the student’s cumulative record in Section 4, LAU Information, in the space designated as “Oral English Proficiency Label.” Print the school name and district name where the CELDT was administered and the student’s English proficiency level. Initial and date the entry.

Materials Needed:

Version G materials provided to the school: • Scannable Test Booklets (consumable) for grades K-2, and scannable

Answer Books for grades 3-12. • Student Test Books for grades 3-12 schools will receive non-scannable

test books for grades 3-12 that can be used repeatedly. • Examiner’s Manuals • Scoring Guides • Group Information Sheets (GIS) • School/Group Lists • Returned test material envelopes • Test Coordinator’s Manual • Large Print and Braille are provided upon request. See Attachment J to

order these tests. • Pre-ID barcode labels for students will be provided for students enrolled in

SIS for grades K-12 prior to the cut-off dates on the “Annual and Initial Critical Dates”. Barcodes will be delivered separately from other materials.

The School/Group Lists, Group Information Sheets (GIS) and Test Coordinator’s Manuals will be packaged together in box one of the test materials. Use separate GIS for the Annual Assessment and for the Initial Identification.

If additional test materials are needed, complete the “Request for Additional CELDT Materials, 2007-2008” (Attachment J) and fax it to the Student Testing Unit at (213) 241-8461.

Test to Administer:

Test Versions • There are 11 versions of Version G. Schools may receive two versions. • Schools that receive two versions will have a different version for each of

these grade spans: K-1 and 2-12. This version information is included on the school’s Packing List found in box one of the test materials.

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CELDT Book Levels The following materials are colored coded: • CELDT Version G Test Books—Forms G1, G2, G3, G4, G5, G6, G7, G8,

G9, G10, or G11. • CELDT Version G Scannable Answer Books (grades 3-12) • Scoring Guide • Examiner's Manual

Grade Span Test Book and Answer Document Color K-1 Book (Consumable) Blue 2 Book (Consumable) Blue

3-5 Book and scannable answer book Red 6-8 Book and scannable answer book Green

9-12 Book and scannable answer book Purple

Preparing for Test Administration:

All test examiners must be annually trained to administer the CELDT. Contact the Local District EL Coordinator for assistance with training. Review the Examiner’s Manuals and Scoring Guides for all tests and levels being administered. Test examiners must become thoroughly familiar with the contents of each test being administered. The Examiner’s Manuals include instructions for all test versions. Test examiners must locate the version they are using. It is recommended that the test examiner bookmark the sections they use. Test administrators are responsible for seeing that testing rooms are appropriately prepared before the students arrive. See LAUSD Testing Notebook, “Requirements” Section.

1. While no time limits have been set for any section of the test, the following

guidelines and time estimations are helpful in planning for a successful administration: • The Listening section should take approximately 15 minutes to

complete. • The Speaking section should take approximately 10 minutes per one-

on-one administration to complete, plus scoring time. • The Reading section should take approximately 50 minutes to

complete. • The Writing section should take approximately one hour to complete.

2. Listening and Speaking sections in Kindergarten:

• Plan appropriate seating for one-on-one administration. 3. Listening and Speaking sections in grade 1:

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• Plan appropriate seating for one-on-one administration for the Speaking section and small groups or individually for the Listening section.

• For the Listening section, Teacher Talk and Extended Listening Comprehension may be administered individually or in small groups.

4. Listening, Speaking, Reading and Writing sections in grades 2-12:

• Allow time between the sections for students to have a break. • The Listening section in grade 2 is administered individually, with the

exception of Teacher Talk and Extended Listening Comprehension test, which may be administered individually or in small groups.

• The Listening section in grades 3-12 is group-administered. • The Speaking section is a one-on-one administration for all grade

levels. • The Reading and Writing sections are group-administered. • The Writing section may be administered in two sessions.

Accommodations and Modifications for Special Education Students When accommodations and modifications are used for students as indicated in their IEPs, the students must be tested in a setting where the special accommodations or modifications can be provided. These accommodations and/or modifications should match what the students are receiving in daily instruction. At the completion of the testing, the test examiner must bubble in Box 22, “Test Variations” when modifications or accommodations are used. The California Department of Education does not allow out-of-level testing for the CELDT. All levels measure the same constructs. Alternate Assessment for Special Education Students

For students with severe disabilities:

1. Attempt to administer all sections of the CELDT to determine

classification and English language proficiency. Record all student responses, even “no response,” on the test booklet or scannable answer books.

2. If the student has severe or profound cognitive challenges or is non-

verbal, as identified on the student’s IEP, he or she should be assessed using the Parent Interview, Teacher Checklist and Communication Observation Matrix (COM) to determine classification and English language proficiency. See Bulletin No. M-120, Guidelines for English Language Learners (ELLs) with Disabilities (K-12), dated (REV.) July 31, 2000, Deputy Superintendent, Instructional Services. At the end of July 2007, the Division of Special Education will issue Bulletin No. 3778.0

3. If the student is assessed using the COM, bubble Box 22 “Alternate

Assessment.” The demographic pages on the CELDT book or answer

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document must be completed and returned as a scorable document.

Preparing Scannable Test Books and Answer Booklets:

Every EL enrolled must have either a scannable answer document with his/her name on the barcode label or a blank document must be bubbled for the student. Submit only completed answer documents for scoring. Barcode Labels

Schools will receive adhesive barcode labels for students in grades K-12 for whom complete data were available in the school SIS on or before the dates listed on Critical Dates. Each sheet of labels has three sections. Each student has three labels. Column one labels have printed text and are informational only--DO NOT USE THESE! Column two labels and column three labels have barcode lines. One of these must be affixed horizontally in the areas indicated on the test booklets. Two barcode labels are provided in case one of the labels is damaged. Retain all unused labels until November 30, 2007. Destroy adhesive barcode labels for any students who are no longer enrolled in the school. Barcode labels will be delivered to the schools according to the schedule on pages 3 and 4 of these instructions. Schools should not wait for the labels before beginning testing. Write the name of the student, the grade, and the birth date on the scannable booklet or answer book for each student. When the barcode labels arrive, affix the labels to the scannable answer books for each student. If a barcode label for a student is not received, the answer document must be hand bubbled.

IT IS ESSENTIAL THAT TEACHERS VERIFY STUDENT NAMES ON BARCODE LABELS AND THAT STUDENTS RECEIVE THE CORRECT SCANNABLE TEST OR ANSWER BOOK. HAND-CODED INFORMATION WILL NOT OVERRIDE THE PRE-IDENTIFICATION DATA.

Completing Answer Documents With Barcode Labels:

The answer documents have numbered sections. The following is to be completed on booklets and answer documents with barcodes for grades K-12: Box 1: Student Name – Print the student’s last name, first name, and middle initial. Box 2: Print the teacher’s name in the space labeled “TEACHER.” Print the school’s name in the space labeled “SCHOOL.” Print “LAUSD” in the space labeled “DISTRICT.” Box B: Darken the bubble for a student using a Braille test form. Box V: For test Versions G1, G2, G3, G4, G5, G6, G7, G8, G9, G10 or G11 the correct version must be darkened.

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Box 10: Test Purpose - Darken "Initial Identification” for students testing the first time for identification purposes. Darken “Annual Assessment” for all previously identified EL students, even if previous scores and grade are not available at this time. Box 12: Date Testing Completed - Print and bubble the date test was completed. Box 18: Testing Irregularities - Report irregularities to the Student Testing Unit at (213) 241-4104 immediately. Then darken bubbles only according to instructions from the Student Testing Unit. Box 22: Test Variations

Accommodations and Modifications Darken the bubble only if this test was administered under the conditions required by the student’s IEP or Section 504 Plan that differ significantly from the test administration guidelines. Alternate Assessment Darken the bubble for students whose IEPs indicate “Alternate Assessment” is needed for language assessments.

Completing Answer Documents Without Barcode Labels:

CELDT Coding Roster for students without barcode labels

To assist schools in preparing the CELDT scannable books and answer books for students without barcode labels, the Student Information System (SIS) has created a CELDT coding roster.

• The Elementary CELDT Coding Roster may be accessed on Screen

20, Special Reports Menu, Option 22 CELDT Coding Roster.

• The Secondary CELDT Coding Roster is NT42. It will print the required data with 3 students per page. It will also have the option to send the data to a file so that it can be imported into other programs (e.g., Excel).

The answer documents have numbered sections. All of the following areas must be completed for answer documents without barcodes. Front Cover Box 1: Student Name - Print the student’s last name, first name, and middle initial. Darken the corresponding bubbles in the name grid, including the blank bubbles for spaces not used by the student’s name. Box 2: Print the teacher’s name in the space labeled “TEACHER.” Print the school’s name in the space labeled “SCHOOL.” Print “LAUSD” in the space

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labeled “DISTRICT.” Box 3: Date of Birth - Print the student’s date of birth. Darken the corresponding bubbles. Box 4: Student’s Primary Language Code - Bubble the student’s primary language using the 2-digit code from Attachment D. Box 5: Primary Disability - Bubble “000” for students without an IEP (including students with Section 504 Plans). For students receiving special education services, fill in the appropriate bubbles for the student’s primary disability code. (See Attachment D for a list of codes.)

Box 6: Gender - Darken the appropriate bubble indicating “Female” or “Male.” Box B: Darken the bubble for a student using a Braille test form. Box 7: Student ID Number (LAUSD District ID)

Columns A-F--Enter and bubble the student’s birth date. Use preceding 0s when needed.

Column G--Enter gender. Bubble 1 for male or 0 for female.

Columns H-J--Enter and bubble the student’s District serial number (the last three digits of the student’s ID number as entered in the SIS.) Schools without SIS should leave columns H-J blank.

Box 8: SSID Number - Bubble student’s assigned Statewide Student Identifier number (formerly called the CSIS number).

Box 9: Grade - Darken the student’s grade level. Box V: For test Versions G1, G2, G3, G4, G5, G6, G7, G8, G9, G10 or G11 the correct version must be darkened.

Box 10: Test Purpose - Darken "Initial Identification” for students testing the first time for identification purposes. Darken “Annual Assessment” for all previously identified EL students, even if previous scores and grade are not available at this time.

Inside Front Cover Box 11: English Learner Date First Enrolled (USA) - Enter and bubble the “Month,” “Day,” and “Year” that the student first enrolled in a school in the USA or one of its territories (American Samoa, Federated States of Micronesia, Guam, Midway Islands, Northern Mariana Islands, Puerto Rico, U.S. Virgin Islands)

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Box 12: Date Testing Completed - Print and bubble the date test was completed. Box 13: Previous CELDT Administration - FOR ANNUAL ONLY If the student took the CELDT last year, darken the “Month” and “Year” when the student’s test was completed. Leave blank if student has not previously taken CELDT. Box 14: Previous CELDT Scale Score - Leave blank. Box 15: Ethnicity - Darken one bubble for “Primary Ethnicity.” If no “Primary Ethnicity” is on file, bubble “Declined To State.” Bubble all that applyfor “Other Ethnicities.” Box 16: Program Participation - FOR ANNUAL ONLY Bubble all specially funded programs in which the student is participating. Use the following guide for program participation for elementary ELs:

CELDT Description Program Description

EL in ELD

• Does Not Apply

EL in ELD and SDAIE

• EL in Mainstream English program at ELD level 5 with program code of P

or • EL with disabilities in SDP at ELD level 5 receiving Master

Plan ELD and SDAIE services with program code of SP

EL in ELD and SDAIE with Primary Language Support (L1 Support)

• EL in Structured English Immersion program at ELD levels 1-4 with program code of EI

or • EL with disabilities in SDP at ELD levels 1-4 receiving

Master Plan ELD, Content-Based ELD, SDAIE, L1 Support services with program code of SI

EL in ELD and Academic Subjects through Primary Language (L1 Instruction)

• EL in Basic Bilingual at ELD levels 1-4 with program code of WB

or • EL in Dual Language program at ELD Levels 1- 5 with

program code of DS or DK or

• EL with disabilities in SDP at ELD levels1-4 receiving Master Plan L1 Instructional service with program code of SW

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Use the following guide for program participation for secondary ELs:

Box 17: Local Use - In columns 1-4 from the left, bubble the 4-digit school location code. Leave the rest blank. Box 18: Testing Irregularities - Report irregularities to the Student Testing Unit at (213) 241-4104 immediately. Then darken bubbles only according to instructions from the Student Testing Unit.

CELDT Description Program Description

Other EL in Mainstream English program at ELD levels 1-4 by parent request with program code of W

None EL with no identified ELD level and no program code/program code of X

CELDT Description Program Description

EL in ELD

• Does Not Apply

EL in ELD and SDAIE

• EL in Mainstream English program enrolled in ESL 3/4 or PRP English course with program code of P or 34

or • EL with disabilities in SDP enrolled in ESL 3/4 or or grade

level English course with program code of SP

EL in ELD and SDAIE with Primary Language Support (L1 Support)

• EL in Structured English Immersion program enrolled in Intro ESL A/B, ESL 1A/B, or ESL 2A/B with program code of EI

or • EL with disabilities in SDP enrolled in Intro ESL 1A/B or ESL

2A/B with program code of SI

EL in ELD and Academic Subjects through Primary Language (L1 Instruction)

• EL in Basic Bilingual or Dual Language programs enrolled in Intro ESL A/B, ESL 1A/B, or ESL 2A/B courses with program code of WB, DS, or DK

or • EL in Dual Language program enrolled in ESL 3/4 or regular

English courses with program code of DS or DK or

• EL with disabilities in SDP enrolled in Intro ESL A/B ESL 1A/B, or ESL 2A/B courses with program code of SW

Other

EL in Mainstream English program by parent request (for students who would otherwise be in ESL 1A-ESL 4) with program code of W

None

EL with no identified ELD/ESL level, not enrolled in an ESL or PRP English course and no program code/program code of X

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Box 19: Student Receives Special Education Services At A Nonpublic Nonsectarian School (NPS) - Darken the appropriate bubble indicating if the student receives special education services at a nonpublic nonsectarian school. Box 20: Nonpublic Nonsectarian School (NPS) (CDS) School Code If the student receives special education services at a nonpublic nonsectarian school, bubble the seven-digit nonpublic nonsectarian CDS school code. Box 21: Student’s Grade During Previous CELDT - FOR ANNUAL ONLY Darken the bubble that indicates the student’s grade during the 2006-2007 CELDT administration. Leave blank if student has not previously taken CELDT. Box 22: Test Variations

Accommodations and Modifications Darken the bubble only if this test was administered under the conditions required by the student’s IEP or Section 504 Plan that differ significantly from the test administration guidelines. (See state guidelines in blue LAUSD Testing Notebook.) Alternate Assessment Darken the bubble for students whose IEPs indicate “Alternate Assessment” is needed for language assessments.

Box 23: Country/District of Residence - Leave blank.

Scoring INITIAL CELDT Documents:

INITIAL CELDT ONLY

All Initial CELDT documents must first be scored locally by trained qualified certificated staff members (teacher credential) to obtain information to use for program placement. This must be completed before submitting the Initial CELDT documents to the Testing Center for official scoring by the state vendor, CTB/McGraw-Hill. The Initial CELDT tests must be scored by completing the CELDT Student Score Sheet. Instructions for scoring can be found in the CELDT Scoring Guide. Two versions of the Student Score Sheet are available for scoring: an electronic version, Electronic Tabulation, Interpretation and Placement guide (eTIP) provided by CTB/McGraw-Hill or by hand scoring using the printed version found in the Scoring Guide. This information will assist in the appropriate student placement in the Master Plan Instructional Program while awaiting official CELDT results.

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To tabulate the CELDT score select one of two methods: • Hand score • eTIP To hand score by completing the Student Score Sheet, follow these procedures: 1. The Scoring Guide provides instructions for scoring the Listening,

Speaking, Reading, and Writing sections of the test. 2. Photocopy one Student Score Sheet per student. 3. Use the Student Score Sheet to record each student’s information. Refer

to the student’s test book for grades K-2 or scannable answer book for grades 3-12. Use the Scoring Guide to complete the Student Score Sheet and calculate the results.

4. Refer to Table 19 “Items to Omit When Calculating Raw Scores” on page

36 of the Scoring Guide to determine which items do not contribute to a student’s score (field test items). Do not count field test items in the raw score.

5. Use the chart on page 22 to determine the student’s interim

language classification. 6. These results should be stored at the school site and used for program

placement until the official CELDT results are returned to the school. 7. File unofficial CELDT results in the student’s Master Plan Folder until the

official results are received from the state vendor. Electronic Tabulation, Interpretation and Placement Guide (eTIP) eTIP is a browser-based application that may be used in place of the Student Score Sheet found in the CELDT Scoring Guides. The application automatically calculates scale scores and proficiency levels from raw scores entered by the user. Each Student Score Sheet must be printed. The application cannot save any results. Use only the 2007-2008 Edition of CELDT Test Administration eTIP available on the CTB website at www.ctb.com/celdt. eTIP Installation Instructions 1. At the CTB website, click on On-Site Scoring Information and Tools. 2. Click the eTIP-MAC version or eTIP-PC version to download eTIP. 3. Choose Save in the File Download window. Then, either accept the

default location, or browse to another location on your computer where you want to install eTIP.

4. An installation wizard installs eTIP in the location you accepted or specified. An eTIP icon is installed on the computer

5. When the installation is complete, double-click on the icon to start the

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program. 6. For questions regarding the eTIP, contact the CTB CELDT Help Desk at,

(800) 994-8594 or by email at [email protected]. To use the eTIP Student Score Sheet, follow these procedures: 1. Click on the eTIP icon. 2. Determine the student’s raw scores following the guidelines in the CELDT

Scoring Guide. 3. Refer to Table 19 “Items to Omit When Calculating Raw Scores” on page

36 of the Scoring Guide to determine which items do not contribute to a student’s score (field test items). Do not count field test items in the raw score.

4. Complete the Information section. 5. Enter the student’s raw score based on the student’s grade-span. 6. Once the Information and Raw Score sections are completed, the Scale

Score section is immediately populated. A student’s English Fluency is also determined in the SBE Guidelines box. Use the chart below to determine the student’s interim language classification.

7. Point to “Calculate Score” and click. The “Unofficial CELDT Result” will appear on the screen.

8. Point to “Print” and click (pop-up blocks may need to be disabled). These results cannot be “saved” on the computer. The unofficial results may be used for program placement.

9. To calculate another student’s score, point to “Clear Form” and click. 10. File unofficial CELDT results in the student’s Master Plan Folder until the

official results from the state vendor are received.

Determining Interim Language Classification and Entering Classification in SIS:

Schools are to use the following chart to determine the interim language classification of the students based on the unofficial CELDT results as described below:

Language Classification Grade

Limited English Proficient (LEP) Initial Fluent-English Proficient (IFEP)

K – 1

Overall CELDT Level = 1 – 3 or

Overall CELDT Level 4-5 & Listening = 1 or 2 Speaking = 1 or 2

Overall CELDT Level = 4 – 5 & Listening = 3 + Speaking = 3 +

2-12

Overall CELDT Level 1 – 3 or

Overall CELDT Level 4 – 5 & Listening = 1 or 2 Speaking = 1 or 2 Reading = 1 or 2 Writing = 1 or 2

Overall CELDT Level = 4 – 5 & Listening = 3 + Speaking = 3 + Reading = 3 + Writing = 3 +

The “unofficial” results may be used for program placement and for determining the interim language classification until the “official” results are received at the school. It is important that interim language classification is

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entered in SIS for these probable ELs to be counted correctly on annual surveys.

Entering Interim Language Classification in SIS

Field Elementary SIS (Enter in Screen 5) Field Secondary SIS (Enter in ID01)

91 Test Name (CELDT) 311 Instrument (C=CELDT)

151 Test Date 312 Test Date

162 Classification (IFEP or LEP) 341 Classification (I=IFEP, L=LEP)

The “official” CELDT results will be downloaded into the school’s SIS when they are received from the state’s vendor.

Maintaining Records of Students Requiring Make-up Testing:

Only complete tests are to be submitted for scoring. Complete tests are those that have all required subtests administered.

Schools are expected to test all eligible students and are responsible for administering make-up tests. Attachment F may be used to maintain records.

Completing the Group Information Sheet:

One Group Information Sheet (GIS) must be placed on top of the test booklets for each grade. See Attachment B for a sample GIS form. Some information will be precoded. Separate GIS forms must be used for the Annual Assessment and for the Initial Identification. Additional GIS forms are available at the school’s assigned Testing Center. Teacher Name - Precoded with the grade level. Do not enter teacher name. School Name - Precoded. Number Tested - Enter and bubble the total number of students tested and included with this GIS. Grade - Precoded. Organization Name, District Name - Precoded.

Completing the School Group List:

The School/Group List is a way to ensure that all documents have been received for all groups the school is submitting for scoring. (See Attachment C for a sample.) Every GIS must have an entry on the appropriate School/Group List. Make additional copies of School/Group Lists. Follow these instructions: Box 1: District Name - Precoded.

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Box 2: School Name - Precoded.

Box 3: County/District/School Code - Precoded. Box 4: Contact Name/Phone Number - Write the name of a contact person and telephone number.

Box 5: Grade - Spell out the grade (e.g., SIXTH GRADE). Box 6: Grade - Write grade numeral (e.g., 6).

Box 7: Number tested - Print number tested. For each grade, the number of students tested must match the number indicated on the corresponding Group Information Sheet.

Prepare the original and two copies of the School/Group List. The original is placed on top of the school’s materials. Keep one copy for the school’s records and provide one copy for the Testing Center.

Packing Scorable Documents:

To ensure that the school’s test reports provide the full range of information they are designed to provide, proper completion of these steps is essential. Failure to follow these directions may cause a delay in processing the school’s test materials. Follow these procedures: 1. Complete the required information on the front of each envelope marked

“For Test Books.” Each grade should be in a separate envelope. Place the Group Information Sheet (GIS) on top of the scannable test or answer books for each grade. If you have a large group and all the scannable test/answer books do not fit in an envelope, use as many envelopes as needed for each group. Mark each envelope of the group, e.g., “1 of X,” “2 of X,” ect. DO NOT SEAL THE ENVELOPES.

2. Place packaged test /answer books in the boxes. Keep groups of documents for the same grade together as you pack. Use as many boxes as necessary. Remove any previous markings or labels from the boxes.

3. Indicate the number of boxes used (e.g., “1 of 3,” “2 of 3,” “3 of 3”) on each box containing materials from the school.

4. Place the completed School/Group List on top of the documents in Box 1. Prepare an envelope for the Testing Center that contains the following:

• Attachment A--Returned CELDT Testing Materials Verification, 2007-2008

• A Copy of School/Group List • A Copy of each GIS Form • Security Affidavits and Security Agreements

5. The Critical Dates section lists two turn-in dates for some calendar/tracks. On the first date, turn in any completed tests you have up to that point. The date with the three asterisks is the final date for that track/calendar. (Three-track calendar, track B will have only one turn-in date on August

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28.) All Annual Assessments must be turned in to the school’s assigned Testing Center by the final date. Annual CELDT turned in after October 19 may not receive official scores. This may affect the school’s bilingual funding.

Handling Unused Materials:

After the Annual CELDT administration has been competed, unused Version G materials are to be retained at the school for Initial Identification. The materials are to be kept in a secure location. Completed Initial Identification test booklets should be returned the second (2nd) Friday of the calendar month to the school’s assigned Testing Center.

Related Resources:

Additional information regarding the CELDT program is available at the following websites: • State link: http://www.cde.ca.gov/ta/tg/el/ • CTB Link: www.ctb.com/celdt • Student Testing Unit Quick Link: • http://notebook.lausd.net/portal/page?_pageid=33,125524&_dad=ptl&_sc

hema=PTL_EP

Assistance: • Independent Charter Schools testing independently from the District, please contact the Charter Office at (213) 241-2665.

• If other districts request CELDT records, have them contact Eva Garcia from School Information Branch at (213) 241-2450.

• For information regarding CELDT training, please contact the Local District EL Program Staff.

• For information regarding Alternate Assessments for Special Education ELs, please contact the Division of Special Education Services, at (213) 241-6701.

• For information regarding Elementary SIS, please contact Elementary SIS Support at (213) 241-4617.

• For information regarding Secondary SIS, please contact Secondary SIS Support at (213) 241-4850.

• For information regarding CELDT test materials, please call the Student Testing Unit at (213) 241-4104.

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Page 27 ATTACHMENT A

RETURNED CELDT TESTING MATERIALS VERIFICATION, 2007-2008

CDS CODE: SCHOOL LOCATION CODE:

SCHOOL: DATE:

CELDT COORDINATOR: PHONE: ( ) Complete two copies of this form and bring them to the school’s Testing Center with the school’s testing materials. One copy is your receipt and one copy will remain at the center.

Check Testing Center:

Avalon Central Monlux San Julian South Valley West Check that these documents are in this box/envelope according to the directions in this document, and indicate number of boxes/envelopes being delivered to the Testing Center.

TO BE COMPLETED BY SCHOOL

FOR TESTING CENTER USE

ONLY

CELDT School/Group List

Copy of School/Group List

Security Agreements for principal and coordinator (required for the first turn-in only)

CELDT Test Security Affidavits for staff members who handled materials and administered the test (Duplicates of Affidavits previously submitted not required)

CELDT Group Information Sheet coded and placed on each grade

Copies of GIS Forms

Number of INITIAL/ANNUAL CELDT documents to be scored (Circle INITIAL or ANNUAL)

FOR TESTING CENTER USE ONLY Qty. of Envelopes Received: ______ Qty. of Boxes Received: _______

Received by: ____________________

Date: ________________

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SAMPLE GROUP INFORMATION SHEET (GIS), 2007-2008 It is essential that a complete and accurate GIS be placed on top of the test booklets for each grade. Some information has already been filled in (precoded). Some information must be hand-entered by the testing coordinator. Please review both the precoded and hand-entered material for accuracy.

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Page 29 ATTACHMENT C

SAMPLE SCHOOL/GROUP LIST, 2007-2008 The School/Group List is CTB's way of double-checking that we have received all groups of answer documents submitted for scoring. Every completed Group Information Sheet must have an entry on the School/Group List. Keep a photocopy of the completed documents for school records.

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Page 30 ATTACHMENT D

PRIMARY LANGUAGES AND PRIMARY DISABILITY TYPE FOR CELDT, 2007-2008 PRIMARY LANGUAGE CODES

CODE LANGUAGE CODE LANGUAGE 56 Albanian 51 Kurdish (Kurdi, Kurmanji) 11 Arabic 47 Lahu 12 Armenian 10 Lao 42 Assyrian 07 Mandarin (Putonghua) 61 Bengali 48 Marshallese 13 Burmese 44 Mien (Yao) 03 Cantonese 49 Mixteco 36 Cebuano (Visayan) 40 Pashto 54 Chaldean 41 Polish 20 Chamorro (Guamanian) 06 Portuguese 39 Chaozhou (Chiuchow) 28 Punjabi 15 Dutch 45 Rumanian 16 Farsi (Persian) 29 Russian 05 Filipino (Pilipino or Tagalog) 30 Samoan 17 French 52 Serbo-Croatian (Bosnian, Croatian, Serbian)18 German 60 Somali 19 Greek 01 Spanish 43 Gujarati 46 Taiwanese 21 Hebrew 32 Thai 22 Hindi 57 Tigrinya 23 Hmong 53 Toishanese 24 Hungarian 34 Tongan 25 Ilocano 33 Turkish 26 Indonesian 38 Ukrainian 27 Italian 35 Urdu 08 Japanese 02 Vietnamese 09 Khmer (Cambodian) 50 Khmu 99 04 Korean

All Other Non-English Languages

CODE PRIMARY DISABILITY TYPE

000 Student receives no Special Education Services, including students with Section 504 Plans

210 Mental Retardation (MR) 220 Hard of Hearing (HH) 230 Deaf (DEAF) 240 Speech or Language Impairment (SLI) 250 Visual Impairment (VI) 260 Emotional Disturbance (ED) 270 Orthopedic Impairment (OI) 280 Other Health Impairment (OHI) 290 Specific Learning Disability (SLD) 300 Deaf-Blindness (DB) 310 Multiple Disability (MD) 320 Autism (AUT) 330 Traumatic Brain Injury (TBI)

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Page 31 ATTACHMENT E1

ANSWER DOCUMENT-FRONT COVER, 2007-2008

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Page 32 ATTACHMENT E2

ANSWER DOCUMENT-INSIDE FRONT COVER, 2007-2008

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Page 33 ATTACHMENT F

TEST RECORD, 2007-2008

STUDENTS REQUIRING CELDT MAKE-UP TESTING

Teacher: Room: Grade:

Name Listening Speaking Reading Writing Complete this form when students miss one or more sections of the test. When make-up testing has been completed, cross out the student's name.

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Page 34 ATTACHMENT G

CELDT TEST SECURITY AGREEMENT, 2007-2008

The California English Language Development Test site coordinator shall ensure that strict supervision is maintained over each pupil while the pupil is being administered the California English Language Development Test. Access to the California English Language Development Test materials is limited to pupils being administered the California English Language Development Test and employees of the school district directly responsible for administration of the California English Language Development Test. All California English Language Development Test district and test site coordinators shall sign the California English Language Development Test Security Test Agreement. The California English Language Development Test Security Agreement shall be as follows: The CELDT test site coordinator acknowledges by his or her signature on this form that the California English Language Development Test materials are secure and agrees to each of the following conditions to ensure test security: 1. I will take all necessary precautions to safeguard all tests and test materials by limiting

access to persons within the school district with a responsible, professional interest in the test’s security.

2. I will keep on file the names of all persons having access to tests and test materials.

I will require all persons having access to the materials to sign the California English Language Development Test Security Affidavit that will be kept on file in the school district office.

3. I will keep the tests and test materials in a secure, locked location, limiting access to only

those persons responsible for test security, except on actual testing dates. By signing my name to this document, I am assuring that I will abide by the above conditions. Print Name: __________________________________________________________________ Signed: _____________________________________________________________________ Title: _______________________________________________________________________ School: __________________________________ Local District: _________________ School District: Los Angeles Unified School District Date: ________________________

DUPLICATE AS NECESSARY

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Page 35 ATTACHMENT H

CELDT TEST SECURITY AFFIDAVIT, 2007-2008 TEST SECURITY AFFIDAVIT FOR EXAMINERS AND PROCTORS

Each California English Language Development Test site coordinator shall deliver the tests and test materials only to those persons actually administering the California English Language Development Test on the date of testing and only upon execution of the California English Language Development Test Security Affidavit. All persons having access to the California English Language Development Test, including but not limited to the California English Language Development Test site coordinator, test administrators, and test proctors, shall acknowledge the limited purpose of their access to the test by signing the California English Language Development Test Security Affidavit. The California English Language Development Test Security Affidavit shall be completed by each test examiner and test proctor. I acknowledge that I will have access to the California English Language Development Test for the purpose of administering the test. I understand that these materials are highly secure, and it is my professional responsibility to protect their security as follows: 1. I will not divulge the contents of the test to any other person through verbal, written, or any other means of

communication. 2. I will not copy any part of the test or test materials unless necessary to administer the test. 3. I will keep the test secure until the test is actually distributed to pupils. 4. I will limit access to the test and test materials by test examinees to the actual testing periods when they are not

taking the test. 5. I will collect and account for all materials following each period of testing and will not permit pupils to remove test

materials from the room where testing takes place. 6. I will not disclose the contents of, or the scoring keys to, the test instrument. 7. I will not review any test questions, passages or other test items with pupils before or after testing. 8. I will administer the test(s) in accordance with the directions for test administration set forth in the contractor’s

manual for test administration. 9. I will return all test materials to the designated California English Language Development Test site coordinator

upon completion of the test. 10. I will not interfere with the independent work of any pupil taking the test and I will not compromise the security of

the test by means including, but not limited to:

A. Providing pupils with access to test questions prior to testing. B. Copying, reproducing, transmitting, distributing or using in any manner inconsistent with test security all or

any portion of any secure California English Language Development Test booklet or document. C. Coaching pupils during testing or altering or interfering with the pupil’s responses in any way. D. Making answer keys available to pupils. E. Failing to follow security rules for distribution and return of secure tests as directed, or failing to account for

all secure test materials before, during, and after testing. F. Failing to follow test administration directions specified in test administration manuals. G. Participation in, directing, aiding, counseling, assisting in, or encouraging any of the acts prohibited in this

section.

I have been trained to administer the test. Print Name: ________________________________________________________________________________ Signed: ________________________________________ Position: _____________________________ School: ___________________________________________ Local District: __________________________ School District: Los Angeles Unified School District_________ Date: ________________________________

DUPLICATE AS NECESSARY

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Page 36 ATTACHMENT I1

TEST ADMINISTRATION PROCEDURES FOR LISTENING

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Page 37 ATTACHMENT I2

TEST ADMINISTRATION PROCEDURES FOR LISTENING AND SPEAKING

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Page 38 ATTACHMENT I3

TEST ADMINISTRATION PROCEDURES FOR SPEAKING

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Page 39 ATTACHMENT I4

TEST ADMINISTRATION PROCEDURES FOR READING AND WRITING

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Page 40 ATTACHMENT J

REQUEST FOR ADDITIONAL CELDT MATERIALS, 2007-2008

SCHOOL: PHONE NO: EXT:

CELDT COORDINATOR: DATE:

PRINCIPAL’S SIGNATURE:

DATE:

REASON FOR REQUEST (Check one): Increase in enrollment Incorrect quantity Please indicate below the number of additional materials required:

GRADE LEVEL K-1 2 3-5 6-8 9-12

ENTER VERSION NUMBER OF EACH GRADE

ENTER QUANTITY OF TEST BOOKS

ENTER QUANTITY OF LARGE PRINT

ENTER QUANTITY OF BRAILLE

EXAMINER’S MANUAL

SCANNABLE ANSWER BOOK

SCORING GUIDE

Materials Quantity Needed

Test Booklet Envelopes

Annual CELDT Test Label Cumulative Card Insert

FOR GROUP INFORMATION SHEETS (GIS) CONTACT YOUR LOCAL TESTING CENTER

FAX order to (213) 241-8461, to Student Testing Unit, 21st Floor, Beaudry Building.

MARK ONE:

o School will send a person who has a signed affidavit to Central Testing Center to pick up materials.

o Materials will be delivered to school.

TESTING UNIT USE ONLY FAXED TO WAREHOUSE

DATE FILLED

FILLED BY

DELIVERY DAY

PICK UP