100%

Nebraska 2026 Domain Exemption Requests Application for ELPA21 Summative or Alt ELPA

Questions marked with a * are required
Date of Request
School District
School District
Name & Email Address
NDE Student ID
Student Grade Level
Student Grade Level
Special Education or 504 Identification and Rationale
Assessment
Assessment
Domain Exemption or Exemptions Requested (You may select up to 3 on rare occasions, but you should select at least one receptive and one productive) 
Please describe the process used to determine this request.
Please Provide an explanation of why no existing accommodations resolve the access issue. 
Please describe how the remaining domain will be tested and how educational decisions will be informed. 
#04-117
For more information about the form, please contact Julie Otero, ESEA Programs English Learner Specialist, Nebraska Department of Education at [email protected]
Powered by QuestionPro