Documentation for Students who are Absent on STAAR Testing Day
Keep this form in your 5 year retention file for each administration on your campus in which you had student(s) that were absent on one or
more testing day.
Campus ________________________
Campus Coordinator ___________________________________
Test Administration: (Month/Year) ___________________________
Testing Program (circle one):
Student’s Name
Grade
STAAR
STAAR-M
PEIMS ID#
STAAR-L
Subject absent for:
Was a make-up
given?
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Score Code
bubbled?
A=Absent
S=Score
A=Absent
S=Score
A=Absent
S=Score
A=Absent
S=Score
A=Absent
S=Score
A=Absent
S=Score
A=Absent
S=Score
A=Absent
S=Score
A=Absent
S=Score
A=Absent
S=Score