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
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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
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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 Name
Last Name
DTC Phone Number
*
-
Area Code
Phone Number
DTC Email
*
example@example.com
Teacher of the Visually Impaired Information
Please provide your TVIs information below.
TVI Name
*
First Name
Last Name
TVI Phone Number
*
-
Area Code
Phone Number
TVI Email
*
example@example.com
District & School Information
Select Your District
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Aberdeen School District #58
Academy at Roosevelt Center (ARC) #460
American Falls Joint School District #381
Arbon Elementary School District #383
Avery School District #394
Ambrose School District
Basin School District #72
Bear Lake County School District #33
Blackfoot School District #55
Blaine County School District #61
Bliss Joint School District #234
Boise School District #1
Bonneville Joint School District #93
Boundary County School District #101
Bruneau-Grand View Joint School District #365
Buhl Joint School District #412
Butte County Joint School District #111
Caldwell School District #132
Camas County School District #121
Cambridge Joint School District #432
Cascade School District #422
Cassia County Joint School District #151
Castleford School District #417
Challis Joint School District #181
Clark County School District #161
Coeur d'Alene School District #271
Coeur D' Alene Tribal School
Compass Public Charter Local Education Agency School #455
Connections Academy #457
Cottonwood Joint School District #242
Council School District #13
Culdesac Joint School District #34
Dietrich School District #314
Emmett Independent School District #221
Falcon Ridge Public Charter Local Agency School #456
Filer School District #413
Firth School District #59
Fremont County Joint School District #215
Fruitland School District #373
Garden City Community Charter School #460
Garden Valley School District #71
Genesee Joint School District #282
Glenns Ferry Joint School District #192
Gooding Joint School District #231
Grace Joint School District #148
Grangeville Joint School District #241
Hagerman Joint School District #233
Hansen School District #415
Hayden Canyon Charter
Highland Joint School District #305
Homedale Joint School District #370
Horseshoe Bend School District #73
Idaho Falls School District #91
Idaho School for the Deaf and Blind
Idaho Virtual Academy
Idaho Virtual High Charter Local Education Agency School
Inspire Virtual Charter Local Education Agency School
ISucceed Virtual High School #466
Jefferson County Joint School District #251
Jerome Joint School District #261
Kamiah Joint School District #304
Kaplan Academy of Idaho #469
Kellogg Joint School District #391
Kendrick Joint School District #283
Kimberly School District #414
Kootenai Bridge Academy #470
Kootenai School District #274
Kuna Joint School District #3
Lake Pend Oreille School District #84
Lakeland Joint School District #272
Lapwai School District #341
Lewiston Independent School District #1
Liberty Charter Local Education Agency School #458
Mackay Joint School District #182
Madison School District #321
Marsh Valley Joint School District #21
Marsing Joint School District #363
McCall-Donnelly Joint School District #421
Meadow Valley School District #11
Melba Joint School District #136
Middleton School District #134
Midvale School District #433
Minidoka County Joint School District #331
Moscow School District #281
Mountain Home School District #193
Mountain View School District #244
Mullan School District #392
Murtaugh Joint School District #418
Nampa Classical Academy #471
Nampa School District #131
New Plymouth School District #372
Nezperce Joint School District #302
North Gem School District #149
North Valley Academy #465
Notus School District #135
Oneida County School District #351
Orofino Joint School District #171
Palouse Prairie School #472
Parma School District #137
Payette Joint School District #371
Pleasant Valley School District #364
Plummer-Worley Joint School District #44
Pocatello/Chubbuck School District #25
Post Falls School District #273
Potlatch School District #285
Prairie Elementary School District #191
Preston Joint School District #201
Richard McKenna Charter High School #453
Richfield School District #316
Ririe Joint School District #252
Robert Janss School #671 (Idaho Department of Correction)
Rockland School District #382
Rolling Hills Public Charter Local Education Agency School #454
Roosevelt Center Charter Local Education Agency School
Saint Maries Joint School District #41
Sage International School #473
Salmon River Joint School District #243
Salmon School District #291
Shelley Joint School District #60
Shoshone Joint School District #312
Snake River School District #52
Soda Springs Joint School District #150
South Lemhi School District #292
Southern Idaho Learning Center #467
Sugar-Salem Joint School District #322
Swan Valley Elementary School District #92
Taylor's Crossing Public Charter Local Education Agency School #461
Teton County School District #401
The Academy (ARC)
Three Creek Joint Elementary School District #416
Troy School District #287
Twin Falls School District #411
Valley School District #262
Vallivue School District #139
Victory Charter Local Education Agency School #451
Vision Charter School #463
Wallace School District #393
Weiser School District #431
Wendell School District #232
West Ada School District #2
West Bonner County School District #83
West Jefferson School District #253
West Side Joint School District #202
White Pine Charter School #464
Whitepine Joint School District #288
Wilder School District #133
Xavier Charter School #462
District Mailing/Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School Name
*
School Mailing/Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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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)
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1
2
3
4
Request #1
*
Kindergarten
First Grade
Second Grade
Third Grade
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
*
Kindergarten
First Grade
Second Grade
Third Grade
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
*
Kindergarten
First Grade
Second Grade
Third Grade
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
*
Kindergarten
First Grade
Second Grade
Third Grade
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
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Final Comments
Comments/Notes
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Submission
Submit
Should be Empty: