Item Writer Questionnaire

Please note: This questionnaire is not an application for ACT employment. The information requested is gathered in order to help ensure appropriate expertise and demographic composition among freelance item writers, soundness consultants, and fairness reviewers as required in ACT's work on resident and contract programs.

Fields marked with an asterisk (*) are required. This form is encrypted for the security of your personal information.

We're having trouble connecting to our system. Please try again in a few minutes.

Please answer the following question only if you are a present or former teacher or curriculum coordinator. If not, please skip to Item 8 (Test Preparation Experience).


Current or Most Recent Responsibilities


Please complete the table and Sections E–H.


Test Preparation Experience


Please complete the following table for all your postsecondary degrees. *


Date Questionnaire Completed





In the fields below, please list three professional references. If you are a secondary educator, one of these references must be your department chair or principal.

A. Reference No. 1


B. Reference No. 2


C. Reference No. 3