2014-15 Physical Fitness Test(Pft) Request For Student Scores Correction Form (Page 2 of 2) in pdf

2014-15 Physical Fitness Test (PFT)

Request for Student Scores Correction

For Office Use Only

Received by: ______________________________

Date: _________________________________

Request reviewed by: ________________________ Date: _________________________________

Approved for data correction in Aeries ____________ Date: __________________________________

(Yes – No)

Rationale: _______________________________________________________________________________

________________________________________________________________________________________

_______________________________________________________________________________________

Requestor notified by: _________________________Date: _________________________________________

Via: phone call _________Email (attach copy)______ U.S. Mail (attach copy): ________ Meeting: ___________

Copy of this form and documents sent to the Assessment and Evaluation Office on:_______________________

(Date and Initials)

Date entered in Aeries by: _____________________ Date: _________________________________________

Aeries PFT score report sent to requestor by:____________ Date:___________________________________

Rationale for Approval / Denial: _______________________________________________________________

_________________________________________________________________________________________

Instructions for School Staff

1. Print PFT score report from Aeries and attach to this form along with documents submitted by

requestor.

2. Copy request and all documents and give to the teacher who administered PFT.

3. Teacher (or school staff) shall refer to the testing documents and WelNet report to verify scores.

4. Teacher (or school staff) reviews and determines if a correction is warranted and indicates by initialing

in the box next to the item whether it’s approved or denied. Indicate rationale for approval or denial.

5. Copy form and documents for the student cum file and the PFT teacher records and forward originals

to the Assessment and Evaluation office.

6. Notify requestor the investigation has been completed and the district administrator will contact them.

7. District Assessment and Evaluation (or designee) will contact requestor.

AUHSD – Assessment and Evaluation

Rev 052915

2014-15 Physical Fitness Test(Pft) Request For Student Scores Correction Form Page 2