Request for ACT Arranged Testing

2013–2014 Request for ACT Arranged Testing
Available only during six designated three-week testing windows.
See request form for dates and deadlines.
ARRANGED Testing
Students approved for Arranged Testing must test with both standard
time limits and a regular type (10-point) test booklet. ACT reviews
requests for arranged administrations for the following students ONLY:
1. Students whose religious faith prohibits Saturday testing AND
a non-Saturday test center is not scheduled within 75 miles
of their home for ANY test date. See the test center listings on
www.actstudent.org.
2. Students in countries where ACT does not have a test center
scheduled for ANY test date. Students are encouraged to travel to
a test center in a nearby country if there is a center scheduled within
reasonable traveling distance. Students visiting in countries where
there are no test centers are encouraged to test before they leave or
after they return to the United States or Canada.
3. Students in the US, US territories, Puerto Rico, and Canada who do
not have a test center scheduled within 75 miles of their home
for ANY test date.
4. Students who are confined to a hospital or the home due to
medical reasons, or to a correctional institution, on ALL test
dates.
ACT will NOT consider Arranged Testing for any other reason or if any of
the above conditions are not met.
Testing for Students with Disabilities
ACT does not provide any test accommodations through Arranged
Testing. Review “Students with Disabilities” on www.actstudent.org for
eligibility requirements and instructions for requesting accommodations
through National or Special Testing.
Arranged Testing Supervisor
It is the student’s responsibility to ask a teacher or counselor at the high
school, college, or university he or she is currently attending to serve as
the test supervisor. (If the student is not currently attending school, ACT
recommends contacting the testing department at a nearby college or
university.) The test supervisor must:
1. Be proficient in English.
2. Be experienced in testing and measurement.
3. Be a staff member of the institution where the arranged
administration will take place.
4. Have control over locked, limited-access storage at the institution to
secure the test materials.
5. Agree to administer the tests according to policies and procedures
in the ACT Supervisor’s Manual Arranged Testing sent with the test
materials.
To protect both the student and the test supervisor from questions of
possible conflict of interest, the following conditions must also be met.
The test supervisor must:
6. Not be a relative or guardian of the student.
7. Not be a private consultant or individual tutor whose fees are paid by
the student or student’s family.
8. Not be engaged in test preparation activities for the ACT ® college
readiness assessment during the current academic year. Only if the
school district contract specifically requires the teacher or counselor
to participate in school-sponsored test preparation courses may that
person serve as supervisor.
9. Not be involved in coaching athletics (required only if the student
participates in athletics).
Test scores achieved under the supervision of an individual who does
not satisfy ALL the requirements will be cancelled automatically without
refund.
Test Options
Two test options are available: the ACT (No Writing), which is made up
of multiple-choice tests in English, mathematics, reading, and science; or
the ACT Plus Writing, which also includes a 30-minute Writing Test.
Taking the Writing Test does not affect the subject area scores or the
Composite score. For more information about the ACT Writing Test, see
www.actstudent.org.
Scheduling the Administration
● Testing Windows. Arranged Testing must be administered on one day
during one of the designated windows listed on the request form. The
February window is available only within the US and Canada.
● Testing Time. Schedule testing at a time mutually agreeable to the
student and supervisor that allows for an uninterrupted session of
approximately 3-1/2 hours for the ACT (No Writing) or 4 hours for the
ACT Plus Writing. ACT prefers that testing be scheduled as the first
activity of the morning. The tests must be administered in a single
session on one day.
Testing procedures allow a short break after the second test. Students
taking the ACT Plus Writing will have time to relax and sharpen their
pencils before the Writing Test. The test session may NOT be
interrupted by longer breaks for meals or other activities. If it is, the
answer document will not be scored or scores will be cancelled.
● Test Location. Testing must be done at the school. IF the student is
confined to the home or another location, you must request
authorization from ACT to administer the tests at that location. Attach a
statement to the request form explaining why the alternate location is
necessary and document your plans for securely transporting the test
materials and ensuring standardized testing conditions at the proposed
location.
Deadlines
Submit your request as early as possible to provide ample time for
review and follow-up correspondence. Your request and payment must
be postmarked (received, if outside the US or Canada) no later than the
deadline listed on the request form for your preferred testing window.
Address:
ACT Arranged Testing
301 ACT Drive
P.O. Box 168
Iowa City, IA 52243-0168
USA
How to Contact ACT
Office hours:
8:30 a.m.–5:00 p.m., central time,
Monday–Friday
Phone: 319.337.1510
Fax: 319.339.3039
E-mail: arranged@act.org
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© 2013 by ACT, Inc. All rights reserved.
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Retest Restrictions
A student may take the ACT no more than 12 times total. A student may
test only once per national, international, or state test date, or Arranged
Testing window. If the retest restrictions are violated, the scores will be
cancelled automatically without refund.
Fee Payment
The test fee, which includes reports for up to four valid college codes
listed on the answer folder is $36.50 for the ACT (No Writing) or $52.50
for the ACT Plus Writing. Payment of the additional $33.00 international
surcharge is required for tests administered in locations other than the
US, US territories, and Canada, for a total of $69.50 for the ACT (No
Writing) and $85.50 for the ACT Plus Writing.
Payment must be in the form of a personal check, cashier’s check, or
money order payable to ACT in US dollars and drawn on a US or US
affiliate bank. Cash will not be accepted. A ticket for a National or
International Test Date from the current testing year will be accepted as
payment if submitted with the request form and payment of the
additional $22 Test Date Change fee.
*NOTICE: This is notification that when you pay by check you are authorizing ACT,
Inc., to convert your check to an electronic entry. When we use this information
from your check to make an electronic funds transfer, funds may be withdrawn
from your account as soon as the same day you make your payment, and you
will not receive your check back from your financial institution. If your check is
returned to us due to insufficient or uncollected funds, it may be re-presented
electronically and your account will be debited.
Instructions for Completing the Request Form
The test supervisor must submit a Request for ACT Arranged Testing for
each student. Incomplete forms, forms not signed by both the test
supervisor and student (or parent/guardian if the student is younger than
18), and forms without full payment will not be processed.
A. Student Information If the student has taken the ACT previously
through Arranged Testing, enter the month and year of the most recent
administration.
B. Supervisor Mailing/Contact Information The name and address of
the institution where you work is required. If you are not employed at
the school the student attends, attach an explanation of your
relationship to the student. Be sure to include your profes sional title
(e.g., counselor, director), street address (for courier shipments),
P.O. Box (if required for mail to reach you), daytime telephone
number, and e-mail address or fax number (if you have one).
C. Test Option and Testing Window Mark one test option and one
testing window. Your request form must be postmarked by the
deadline listed or you may not be approved to test during your
preferred window.
D. Reason for Arranged Testing Check one.
● Students whose religious faith prohibits Saturday testing must
submit a letter from their cleric or a notarized statement to
verify the prohibition.
● Students who are confined to their home or another location on all
test dates must include documentation by a qualified professional
to support the diagnosis as well as verify the length of their
confinement. Copies of diagnostic records and a copy of the
homebound plan filed with the school must be submitted with the
request form.
● Students with no test center in the country for any test date or no
test center within 75 miles (US and Canada only) on any test date
must provide an accurate mailing address. If ACT determines that
the student has a test center scheduled on any test date within 75
miles (or within the country outside the US or Canada), Arranged
Testing will not be approved. The student must then register to test
through National or International Testing.
E. Supervisor Statement Sign and date your agreement to the
conditions listed. The name signed must be the same as the person
listed in Section B.
F. Student Statement The student must read and sign the statement. If
the student is younger than 18, a parent or legal guardian must sign.
G. Fee Payment The form will not be processed without full payment.
H. Return of Request Form Follow these steps:
1. Keep a photocopy of the completed request form for the student’s
files.
2. Check the form for completeness and both signatures; incomplete
and/or unsigned forms will not be processed.
3. Include all documentation specified in Section D.
4. Include the student’s full fee payment.
5. Mail the form to the address listed. Do not have the student
register.
6. Send the request form as far in advance as possible. The form
must be postmarked (received, if outside the US or Canada) no
later than the deadline for your preferred testing window.
7. Keep this brochure for your reference.
Response from ACT
If the form is missing any information, signatures, or full payment, the
request will not be processed. If Arranged Testing is approved by ACT,
test materials will be shipped to arrive no later than one week prior to the
first day of the testing window. The student will NOT receive a ticket.
Assignment of Test Materials
Test materials may be used ONLY for the student(s) listed on the Test
Materials Distribution List and may NOT be transferred to any other
location or student. If the student(s) does(do) not test, the test materials
must be returned to ACT immediately with an explanation as to why the
materials were unused.
Answer Folder(s)
A Universal Answer Folder for each student will be shipped to the test
supervisor. Identifying information (required), responses to the ACT
Interest Inventory and Student Profile Section (optional sections), and
college choices (up to six) must be recorded on this folder prior to test
day. Answers to the multiple-choice tests will be recorded on this answer
folder on test day. If the student is taking the ACT Plus Writing, a
Universal Plus Writing Answer Folder will also be included.
If the Student Does Not Test
The test fee for the ACT (No Writing) and international surcharge (if
applicable) are nonrefundable, even if the student does not test.
Test Date Change: A student who does not break the test booklet seal(s)
within the designated testing window may request a Test Date Change.
To do so, the student and supervisor must sign a written request
specifying the new testing window and submit it with payment of the
additional $22 fee. The request must be postmarked by the deadline for
the new testing window. Test Date Change requests will not be
considered until after ACT receives the unused test materials.
Refund Request: A student who registered and paid for the ACT Plus
Writing who does not take the Writing Test may request a refund of the
$16.00 Writing Test fee by writing to Arranged Testing. Refunds are not
issued until after ACT receives the unused test materials. Refund
requests for the 2013–2014 testing year received after July 31, 2014, will
not be honored.
Retesting
Each time a student wishes to test through Arranged Testing, a new
request form must be submitted with full payment for the preferred test
option and any required supporting documentation.
Supervisor Compensation
Only the person who administers the tests will be compensated. ACT will
notify the supervisor of the compensation amount after Arranged Testing
is approved. ACT treats all testing staff as independent contractors.
Therefore, wages are not subject to income tax withholding and Social
Security deductions. ACT reports the income to the IRS only if payments
to an individual exceed $600 in a given year. A payment report form will
be sent with the test materials.
Score Reports
Reports for the ACT (No Writing) are nor mally mailed within 3–8 weeks
after ACT receives the answer folders; score reports for the ACT Plus
Writing are normally mailed within 5–8 weeks. The Test Location is
reported as “School.”
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2013–2014 REQUEST FOR ACT ARRANGED TESTING
To be completed by the Test Supervisor. Please type or print clearly.
A.
STUDENT INFORMATION
Last Name First Name Middle Initial
C.
TEST OPTION Mark one.
n ACT (No Writing)
n ACT Plus Writing
Street Address
Apartment No.
City, State/Province, ZIP/Postal Code Country (if outside US)
Phone Number (with Area Code)
Date of Birth
E-mail Address
High School Code or College Code (if attending)
TESTING WINDOW
Mark one and send your request no later than the deadline for that
window—receipt deadline if outside the US and Canada.
Testing Window
Deadline
n Sept. 21–Oct. 13, 2013 Aug. 23, 2013
Oct. 26–Nov. 17, 2013 Sept. 27, 2013
n
n
n
n
n
Dec. 14, 2013–Jan. 5, 2014 Nov. 8, 2013
Feb. 8–March 2, 2014* Jan. 10, 2014
Apr. 12–May 4, 2014 Mar. 7, 2014
June 14–July 6, 2014 May 9, 2014
*February window available only in the US and Canada.
Detach here before mailing.
Date of Previous ACT Arranged Testing (if applicable)
B. SUPERVISOR MAILING/CONTACT INFORMATION
Name
Professional Title
School (if not the student’s school, must attach explanation)
Street Address (required to ship test materials)
P.O. Box (if required)
D. REASON FOR ARRANGED TESTING. (Check one and
include any required documentation.)
1. n (04) Religious Faith Prohibits Saturday Testing AND No
Non-Saturday Test Center Established for Any Test
Date Within 75 Miles. Include letter from a cleric or a
notarized statement to verify the prohibition.
2. n (05) No Test Center in the Country for Any Test Date.
3. n (08) Within the US or Canada only, NO Test Center
Established for Any Test Date Within 75 Miles.
4. n (06) Homebound (confined to home due to medical reasons)
on All Test Dates. Include a copy of the homebound
plan filed with the school and documentation of the
diagnosis/length of confinement.
5. n (09) Confined to a Hospital on All Test Dates. Include
documentation to support this accommodation.
6. n (10) Confined to a Correctional Institution from September
2013 through June 2014.
City, State/Province, ZIP/Postal Code
Country (if outside US)
Phone Number (with Area Code)
Fax Number (with Area Code)
E-mail Address (required)
E. SUPERVISOR STATEMENT (Signature required for ALL requests.) I certify that I personally meet ALL the requirements for test
supervisor specified by ACT (see page 1, Arranged Testing Supervisor) and that I or a member of my staff who also meets the same requirements
will administer the tests in accordance with the ACT Supervisor’s Manual sent with the test materials. I will ensure that the test materials are kept
secure and confidential, used for this student only and not transferred to another student or location, and returned to ACT immediately after
testing.
Supervisor’s Signature
Date
F. STUDENT STATEMENT (Signature required for ALL requests.) I verify that the information provided on this form and in the
attached documentation, if any, is accurate to the best of my knowledge. I authorize the release of any documentation attached to ACT.
Student’s Signature (parent or guardian must sign if student is under 18)
G. FEE PAYMENT. The test fee for the selected test option (and the international surcharge, if applicable) must be submitted with this form or it
will NOT be processed. Fees are: ACT (No Writing) $36.50; ACT Plus Writing $52.50. Tests administered in locations other than the US, US
territories, and Canada require an additional $33.00 international surcharge—$69.50 total for ACT (No Writing) and $85.50 for ACT Plus Writing.
H. RETURN OF REQUEST FORM. Detach and mail this completed form, any required supporting documentation, and full fee payment to: ACT
Arranged Testing, 301 ACT Drive, P.O. Box 168, Iowa City, IA 52243-0168, USA. Faxed forms will not be accepted.
Date
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