STAR Grade 2 Math Transparencies Request Form

Page 1

2010 Standardized Testing and Reporting:Request for STSfor Mathematics (Grade 2) Test Response Transparencies

Note:2010STAR Standards-based Tests in Spanish (STS) forMathematicstest response transparencies for grade two must be kept secure and are not to be copied. STS for Mathematics transparencies are to be returned to the STAR Processing Center in the box of nonscorable materials with the grade twoSTS Directions for Administration following the administration of the multiple-choice test.

Fax this form to STAR TAC at 800-541-8455 at least four weeks before the test administration.Transparencies will be shipped to the shipping contact listed in Part 2.

Part 1. Test Administration and Number of Transparency Sets Information
Number of schools requiring transparencies: / School districts: Use Part 4 on the second page of this form to list schools and the number of sets of STS for Mathematics (Grade 2) test answer transparencies per school. Requests made without a list of schools cannot be processed.
Number of sets of transparencies:
First multiple-choice administration dates (from–to):

Part 2. Shipping Information

Person making the request / Telephone number
School district name orcharter school name / CDS code orcharter school code
Shipping address, line 1
Shipping address, line 2
Shipping address, line 3
Shipping contact name
District STAR Coordinator signature / Date signed
Part 3. Instructions for Distributing Transparencies
District STAR Coordinators / Test Site Coordinators
Before testing / Include with school’s shipment of test materials. Instruct test site coordinators to return to the school district with grade twoDFAs. / Store the transparencies securely. Distribute to the appropriate second grade teacher(s) on the day of testing only.
After testing / Return transparencies to the STAR Processing Center by packing with grade twoDFAs in the box with the green label. / Return transparencies to the district STAR coordinator by packing with grade twoDFAs in the box with the green label.
2010 STAR:Request for STS for Mathematics (Grade 2) Test Response Transparencies
Part 4. List of District Schools

School districts: Use this page to list schools and the number of sets of STS forMathematics (Grade 2)test response transparencies per school. Because different schools within a school district can be assigned different versions of the grade twoSTS, requests made without a list of schools cannot be processed. Photocopy this page to add more schools.

Test response transparencies are only for students who receive instruction in American Sign Language (ASL) and will have test questionspresented in ASL as designated in the student’s individualized education program (IEP) or Section 504 plan.

School district name:
# sets / School name / School’s CDScode / School’s testing window

This form may be photocopied.