Assessment Forms

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District Assessment Coordinator (DAC) and District Technology (DTC) Update Forms

DAC Update Form - This form must be completed every year by District Assessment Coordinators (DACs) to assure that DPI has the most recent contact information for updates via mail or email.

DTC Update Form - This form must be completed every year by District Technology Coordinators (DTCs) to assure that DPI has the most recent contact information for updates via mail or email.

Confidentiality Forms

DAC Confidentialtiy Agreement Form – The DAC Confidentiality Agreement Form must be completed by the designated district assessment coordinator (DAC) each school year. The DAC Confidentiality Form encompasses all (Forward, ACT/PreACT Secure, DLM, WIDA ACCESS) state assessments. Once completed, this form should be sent to osamail@dpi.wi.gov.

Other Confidentiality Forms

The following forms must be completed by the appropriate staff each school year. Once completed, these forms should be retained at the district/school level.

Forward Confidentiality forms 

A confidentiality form must be completed by anyone who works with or views the Forward Exam testing materials or reports.

Forward School Assessment Coordinator (SAC) Confidentiality Agreement

Forward District Technology Coordinator (DTC) Confidentiality Agreement

Forward School Technology Coordinator (STC) Confidentiality Agreement

Forward Test Administrator (TA) Confidentiality Agreement

Forward District and School Report User Confidentiality Agreement

Forward Exam Read Aloud Agreement to Maintain Security and Confidentiality 

ACT/PreACT Secure Confidentiality forms 

A confidentiality form must be completed by anyone who works with or views the ACT/PreACT Secure testing materials or reports.

ACT Test Coordinator Confidentiality Agreement

ACT Room Supervisor/Proctor Confidentiality Agreement

ACT District/School Technology Coordinator Confidentiality Agreement

Dynamic Learning Maps (DLM) Confidentiality forms 

A confidentiality form must be completed by anyone who works with or views the DLM testing materials. There is no DPI DLM Confidentiality Form for Test Administrators/Proctors as they are required to sign an equivalent electronic form prior to accessing the portal.

DLM SAC Confidentiality Agreement

DLM DTC Confidentiality Agreement

DLM STC Confidentiality Agreement

DLM District and School Report User Confidentiality Agreement

WIDA ACCESS Confidentiality forms 

A confidentiality form must be completed by anyone who works with or views the WIDA ACCESS testing materials.

WIDA ACCESS SAC Confidentiality Agreement

WIDA ACCESS DTC Confidentiality Agreement

WIDA ACCESS STC Confidentiality Agreement

WIDA ACCESS TA Confidentiality

WIDA ACCESS District/School Staff Confidentiality Agreement

Forward Exam Confirmation of Destruction Form

Accommodation Request Forms

Test Security Incident Report Form

Significant Medical Emergency (SME) Form

Extended Testing Hours Forms

Forward Data and Reporting Forms

Forward Exam Rescore Form - Use this form to submit a re-score request for approval by DPI and processing by DRC. Please note this form is for public, charter, and choice students, only.

Forward Exam Decline Paper ISRs - District Assessment Coordinators (DACs) should complete this form to decline the receipt of paper Forward Exam ISRs for their district.