SECOND LANGUAGE PROFICIENCY EXAMINATIONS

School Record of Examinations Requested

This form may be photocopied by the school and used in any of several ways:

· As a worksheet for preparing your school’s submission to the Online Examination Request System

· For circulation to department chairpersons, special education coordinators, and other school officials for reporting their examination needs to your school’s central office on a
subject-by-subject basis

· For distribution to other principals in your district when your school is requesting quantities of test booklets for use in other schools

Be sure to retain in your files the final version of this form (i.e., the one representing the completed request actually submitted via the online request system to the Department). You will need to use that version for checking the confirmation notice that will be sent to you via e-mail within several days of the submission of your online request to the Department.

School Name

Date

LANGUAGE	REGULAR	LARGE TYPE	BRAILLE
SLP FRENCH
SLP GERMAN
SLP ITALIAN
SLP LATIN
SLP SPANISH