ACT - Residual Test Materials Order Form 2017-2018

1 Residual Test Materials Order form 2018 2019 Scheduled Test Date: / / Allow at least four weeks for delivery from the date you submit the Order . Four-Digit College Code: Multiple-Choice Residual Testing Materials Quantity Item Description Test Booklet Contains the multiple-choice ACT test (English, mathematics, reading, and science). Booklets are reusable if stray marks are removed. Universal Answer Folder 2 Machine scored by ACT; may be handscored locally using an acetate overlay and conversion table (see Scoring Key Packet). Universal Answer Folder 3 Answer Sheet Type: NCS Sentry 70 Scantron Universal Answer Folder 3 used for recording scores collected from answer sheets. Answer sheets used by examinees to mark responses to test questions. Choose the appropriate answer sheet type for machine scoring on campus. The ACT Test Administration Manual Residual Testing Provides policies and procedures for ordering, securing, administering, and returning test Materials .

2 Order one manual per test room. Scoring Key Packet Acetate overlay or paper key and conversion table for local scoring. Site Header and Answer Document Return Envelope Used to return answer documents for processing. Order one set per test date. Writing Test Residual Testing Materials Writing Package Package contains 10 writing test booklets and 10 writing answer documents. Package contents are not reusable, refundable, or exchangeable. Use one test booklet and answer document per student in combination with the corresponding Universal Answer Folder 2 or 3. Fees Multiple-Choice ACT will bill your institution for each answer folder scored. $ Writing Package ACT will bill your institution for each package ordered. $ Shipping Address ACT Residual Test Coordinator Name Institution Shipping Address (do not use a PO Box) City State ZIP Telephone Email Billing Address Billing Contact Name Institution Address City State ZIP Note: Customers will be charged applicable state and local sales taxes where required.

3 A list of states where ACT is registered to collect and remit sales tax can be found at If required, calculate appropriate sales tax based on your shipping address and add to the Order total. If you are exempt from sales tax, appropriate documentation must be received by ACT before tax-exempt status will be granted. Purchase Order If a purchase Order is necessary for billing, provide the purchase Order number: _____ Note: If your institution cannot supply a purchase Order to cover the entire testing year, include a purchase Order with each batch of answer documents sent to ACT. It is the institution s responsibility to provide ACT with a current purchase Order . Agreement Residual Test Coordinator s Agreement: I will ensure that the test Materials are kept secure and confidential, used only for Authorized Examinees, and returned to ACT immediately after testing. I agree to administer the ACT according to procedures provided by ACT.

4 I certify that neither I, nor my testing staff, are: a relative or guardian of the examinee a private consultant or individual tutor whose fees are paid by the examinee or examinee s family engaged in test preparation activities for the ACT involved in coaching high school or college athletics receiving any compensation outside of ACT for administering the test By signing below, I hereby agree to the Standard Terms and Conditions For Purchase of ACT, Inc. s Paper-Based The ACT Test Materials and Related Services. I understand that by agreeing to be a Residual test coordinator, I consent to the ACT Privacy Policy ( ), which is incorporated herein by reference, including consent to the collection of my personally identifying information and its subsequent use and disclosure. International Residual Test Coordinators: By my signature, I am also providing my consent to ACT to transfer my personally identifying information to the United States to ACT or a third-party service provider for processing, where it will be subject to use and disclosure under the laws of the United States.

5 I acknowledge and agree that it may also be accessible to law enforcement and national security authorities in the United States. Residual Test Coordinator s Signature Date Submit the completed form to: 2018 by ACT, Inc. All rights reserved. STANDARD TERMS AND CONDITIONS FOR LICENSE OF ACT, INC. S PAPER-BASED THE ACT TEST Materials AND RELATED SERVICES UNLESS THE RECEIVING ENTITY ( CUSTOMER ) HAS A FULLY EXECUTED WRITTEN AGREEMENT WITH ACT COVERING THE PRODUCTS CONTAINED IN THIS SHIPMENT ( PRODUCTS ) AND THEIR RELATED SERVICES, THE FOLLOWING TERMS AND CONDITIONS SHALL APPLY: Any of the following acts constitute Customer's acceptance of the terms and conditions contained herein: (a) Customer's placing of an Order for the products and services, (b) Customer's use of the products and services, (c) Customer's payment for the products and services ordered.

6 If Customer does not agree, it should not use the products. ACT will only report scores earned through the Residual administration of the ACT to the administering college. ACT will not share scores with other colleges, scholarship agencies, or any other entities. The test coordinator must notify examinees that scores are for internal use at the administering institution only. Students must read and agree to the terms and conditions of testing provided in the Taking the ACT test booklet and attest to them on the test Materials provided during the administration. 1. Term. This Agreement shall become effective as of the date that ACT accepts the Customer's Order and shall remain in effect until ACT completes the scoring and reporting services that have been ordered, subject to earlier termination as set forth in Sections 10 and 12. 2. Payment Terms. Customer agrees to pay ACT for the products and services at ACT's prevailing rate.

7 Customer shall make all payments within thirty (30) days of receipt of an invoice from ACT. 3. License. Subject to the terms of this Agreement, ACT grants you a limited, revocable, non-exclusive, non-sublicensable right to use the assessments and all related Materials , and all intellectual property rights therein (collectively, the ACT Materials ) in connection with the testing policies and procedures provided by ACT. 4. Ownership of Materials . ACT is the owner of the ACT Materials and all intellectual property rights to it, including but not limited to, copyright and trademark. Customer s interest is strictly that of a licensee subject to the terms of this Agreement. Customer does not acquire any right, title, or interest in or to the ACT Materials . Customer shall not copy, modify, enhance, reverse engineer, or make any addition to the ACT Materials without the prior written consent of ACT.

8 5. Confidentiality. Customer agrees that neither it nor its employees shall at any time, either directly or indirectly, publish, display or otherwise disclose to any person, organization, or entity in any manner whatsoever any ACT Materials , except as strictly necessary for Customer to administer the assessments to the Authorized Examinees. The term Authorized Examinees means individuals who are employees or prospective employees of the Customer. If the Customer is a school, the term also includes the individuals who are prospective or registered students of that school. If the Customer is a non-profit government funded agency, such as a Workforce Investment Board or a One Stop Center, the term also includes individuals whose Assessments have either been paid for directly by the individual, or whose Assessments have been paid for by such government funding or by an educational institution.

9 The term individual" means a human being and does not include a partnership, corporation, association, cooperative, or other legal entity. Customer shall protect the ACT Materials in accordance with ACT's procedures and use a standard of care appropriate for secure test Materials . All ACT Materials shall be and remain the property of ACT. The ACT Materials shall, within ten (10) days of ACT's written request, be returned to ACT (including any copies thereof). 6. Testing Procedures. Customer agrees to administer the Assessments in accordance with all policies and procedures provided by ACT. Customer shall store the ACT Materials at secure location(s) approved by ACT. Customer agrees that all used and unused ACT Materials will be returned to ACT, in accordance with the policies and procedures provided by ACT, for scoring and/or processing. Customer agrees to fully cooperate with ACT, and cause those individuals involved in the administration of or preparation for the Assessments ( Administration Staff ) to fully cooperate with ACT in the event of a test security incident.

10 Customer acknowledges that failure to maintain the confidentiality of the Assessments will result in damages to ACT and may require ACT to develop a replacement form . Accordingly if through the fault of Customer or Administration Staff, the security of an Assessment is compromised, Customer agrees to pay ACT the costs of developing a new form in addition to any other remedies under the law. ACT may, in its sole and absolute discretion, cancel scores in cases of testing irregularities, which may include without limitation, use of a compromised test form , falsification by an examinee of his/her identity, impersonation of another examinee (surrogate testing), unusual similarities in the answers of examinees at the same test center, or other indicators that the test scores may not accurately reflect the examinee s level of educational development. 7. Data. The parties acknowledge and agree that ACT may use and disclose the data collected from the administration of the Assessments, as set forth in ACT s Privacy Policy available at , as amended from time to time.