The School District of Philadelphia Form Office of Curriculum, Assessment, and Instruction (Per Room) Room Number: Test Administrator: Test Administrator’s Signature School Test Coordinator’s Signature Number Date and Number Date and of Time of Time Booklets Issued Booklets Issued DIRECTIONS Each Test Administrator must sign this form when test booklets are issued. The Test Coordinator must sign when test booklets are returned, immediately testing is completed. Please retain all Chain-Of Custody forms for your records, for three years. THIS FORM SHOULD BE COMPLETED FOR EACH DAY OF TESTING.
The School District of Philadelphia Office of Curriculum, Assessment, and Instruction Form (Per Room) Room Number: Test Administrator: Number of Booklets Test Administrator’s Signature Date and Time Issued Number of Booklets School Test Coordinator’s Signature Date and Time Issued DIRECTIONS Each Test Administrator must sign this form when test booklets are issued. The Test Coordinator must sign when test booklets are returned, immediately testing is completed. Please retain all Chain-Of Custody forms for your records, for three years. THIS FORM SHOULD BE COMPLETED FOR EACH DAY OF TESTING.
Chain-of-Custody-Per-Room-Final.docx