District Braille IRI Assessment Materials Request

District Braille IRI Assessment Materials Request

Districts will use this form to request Idaho Reading Indicator (IRI) braille materials. Requests for braille materials for multiple grades can be made using one form. One order will include both teacher and student materials. Only order what you will use each test administration window. Materials need to be returned to SDE after the close of the testing window.
Submission Deadline

September 2, 2022

This form is intended to be completed by District Test Coordinators.

In order to avoid confusion in ordering, please complete this form only if you are the DTC. If you are a Teacher of the Visually Impaired, please confirm with your DTC that they have included your request. If you have any questions about the ordering process, please reach out to the State IRI Coordinator, Marissa Gravel, at mgravel@sde.idaho.gov.
I confirm that I am the District Test Coordinator*

Acknowledgement

District Test Coordinator Information

If you are the DTC, please fill in your information below. If you are not the DTC, please provide their information below.
DTC Name*

First NameLast Name
DTC Phone Number*

Area CodePhone Number
DTC Email*
example@example.com
Teacher of the Visually Impaired Information

Please provide your TVIs information below.
TVI Name*

First NameLast Name
TVI Phone Number*

Area CodePhone Number
TVI Email*
example@example.com
District & School Information
Select Your District*
District Mailing/Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Name*
School Mailing/Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Materials Request

You can request materials for multiple grade levels using one form.
Please select the number of grade levels you would like to order. (Keep in mind that each grade level will be specified below)*

1234
Request #1 *
Select Grade Level
Number of Test Booklets Requested*
For Request #1: Each booklet will contain both the teacher and student materials for 1 student to be assessed
Request #2*
Select Grade Level
Number of Test Booklets Requested*
For Request #2: Each booklet will contain both the teacher and student materials for 1 student to be assessed
Request #3*
Select Grade Level
Number of Test Booklets Requested*
For Request #3: Each booklet will contain both the teacher and student materials for 1 student to be assessed
Request #4*
Select Grade Level
Number of Test Booklets Requested*
For Request #4: Each booklet will contain both the teacher and student materials for 1 student to be assessed

Submission Deadline