WorkKeys Testing Irregularity Report

The following form should be used to record any test administration irregularity that may affect user scores or the interpretation of the WorkKeys results, or that result in voiding one or more assessments. One form may be completed to report an irregularity that affects an entire group of examinees (e.g., power failure, fire drill, network failure, etc.); however, the name of each examinee affected should be entered into the "Name of Examinee" field. A separate form must be completed for each examinee experiencing a different irregularity (e.g., sudden acute illness of an examinee, user questions an item, user is using an unauthorized testing aid, etc.).

NOTE: Always keep a copy of your completed form on file for future reference.

Name of Site
Site Number
Room Name/Number
City
State
ZIP
Name of Examinee
Time of Irregularity
Description of Irregularity
Administrator Name
Email
Date of Irregularity	(mm/dd/yyyy)