ࡱ> WYVQ bbjbj 0Hveivei01 ***8bl|*$,&JJ(rrraaa+++++++$J.1+aaaaa+rr+ajrr+a+(hC)r o(++0$,(1e1 C)1C)Laaaaaaa++kaaa$,aaaa1aaaaaaaaa X : Student Application for entitlement to Special Assessment Conditions Candidate or parent / guardian to complete for the school (To be signed by the student and retained on file in school together with the supporting evidence) Candidates name (first name family name)  NSN:  Date of Birth : (dd/mm/yyyy)  Year Level:  For my NCEA assessments I request .College / High School apply to ɫֱ for entitlement to (more than one box may be ticked in each section) use of an aide (e.g. writer and/or reader or signer). Specify:  additional time or rest breaks to complete assessments. Specify:  use of technology to complete and present work (e.g. computer). Specify:  other (e.g. enlarged papers). Specify: for my  sensory impairment (sight, hearing)   medical condition   physical condition   learning disorder  that directly impacts on my ability to be fairly assessed.  I agree to this information including any reports and testing data held by the school being released to ɫֱ in support of my application for entitlement to Special Assessment Conditions. I understand that the school will consider my application for entitlement against the criteria listed in the Assessment and Examination Rules for Schools. They may decide to provide me with additional learning support and/or not apply to ɫֱ. I understand that ɫֱ may decline or amend the entitlement I have requested. 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