(Must be printed on official institution letterhead)
How to Complete and Submit the Form
This form may be submitted to fulfill documentation requirements for an examinee requesting select alternative testing arrangements in lieu of submitting documentation to Evaluation Systems.
Authorized institutional representatives should work with examinees to complete the following steps:
Complete each field on the form.
Save an electronic copy of this form.
Print the form on institution letterhead and provide your institutional representative signature. Note that ALL pages must be printed on letterhead stock.
Scan it into a document or image file format.
The examinee must then submit the completed document electronically, along with the completed Alternative Testing Arrangements Request Form, via the uploader tool on the Contact Us page of the program website (www.va.nesinc.com/Contacts.aspx).
For assistance completing this form, please see the Virginia Communication and Literacy Assessment program website for contact information at: www.va.nesinc.com/Contacts.aspx.
Requirements for Processing Requests
This form must be completed in its entirety, signed by an authorized institutional representative from the Office of Disability Services at the examinee's college or university, or signed by an authorized professional at the Department of Vocational Rehabilitation office in the examinee's state of residence, and printed on official institution letterhead.
This form will only be accepted as supporting documentation for the alternative testing arrangement(s) listed in section 8 of this form.
Print this form on institutional letterhead. You may "save as PDF" first to save it,
and then print it on institutional letterhead when you are able to do so.