Kentucky Department of Education

 

Forms

Last Updated on Saturday, February 04, 2012 at 10:03 PM

The Division of Support and Research has created a number of forms that can be downloaded for use by schools and districts in implementing the state's Assessment and Accountability Program.

These forms are applicable to

Kentucky Performance Rating for Educational Progress (K-PREP)

K-PREP Alternate Assessment

EXPLORE

PLAN

ACT

K-PREP End-of-Course (QualityCore)

COMPASS

 

2011-2012 MEDICAL EXEMPTION FORM to request that student be granted a medical exemption from the statewide and accountability program for students in the regular assessment program (Note: a student's handicapping condition, if any, cannot be the basis for a medical exemption)

INFORMATION FOR THIS FORM MUST BE SUBMITTED ELECTRONICALLY VIA SDRR. KEEP PAPER FORM ON-FILE IN DISTRICT.

HIPPA Form

2011-2012 Medical Exemption Form HIPAA Form

2011-2012 Extraordinary Circumstances Exemption Form 

This replaces the Other Exemption Form.

INFORMATION FOR THIS FORM MUST BE SUBMITTED ELECTRONICALLY THROUGH SDRR. KEEP PAPER FORM ON-FILE IN DISTRICT.

2011-2012 Extraordinary Circumstances Exemption Form

2011-2012 MEDICAL EMERGENCY FORM to be used for medical emergencies that require accommodations during testing that are not a part of an IEP, 504 Plan or PSP.

ANNOTATE THE ACCOMMODATION GIVEN ON THE APPROPRIATE ROSTER. KEEP PAPER FORM ON-FILE IN DISTRICT.

2011-2012 Medical Emergency Form

Spring 2012 Seating Chart

2012 Spring Seating Chart

 

Nondisclosure Agreement sets conditions for access to secure testing materials

Nondisclosure Form
Notification Form to inform authorities of alerts papers and their contents Notification of Authorities Form Notification of Authorities Form

Notary Statement Form for collecting allegation incident information

Allegations Reporting Website

Allegation Reporting Form

Kentucky Notarized Statement 2010 Allegation Reporting Form 2010 Allegation Reporting Form
For more information contact:

Assessment Information
500 Mero Street, 18th Floor CPT
Frankfort, KY 40601
Phone: (502) 564-4394
Fax: (502) 564-7749
dacinfor@education.ky.gov