Form B
(Application for Candidates with SpLD and/or AD(H)D)
Candidates should fill in the General Application Form A and the relevant application form
according to the impairment for which the application is being made. All relevant
certification and documentation should be attached and submitted to the MATSEC Support
Unit.
Please read carefully
It should be noted that deadlines for applying for MATSEC examination access arrangement (EAAs)
are not extended in the same way as deadlines for the registration of MATSEC examinations. The
deadlines for EEAs need to be respected since the process involved in vetting access arrangements is
different and longer. Moreover, the committee processing requests for access arrangements needs to
forward the arrangements to the Examinations Department that is responsible for making the
arrangements. It would be difficult to provide resources, which include physical space and
Examination Access Arrangements Support Assistants (EAASAs), if approval is given late.
•
Candidates should check the MATSEC website for the dates by which applications for access
arrangements should be submitted without assuming they are the same as the deadlines for
registrations for examinations. Refer to Table 3 on p. 20 of the “Guidelines for MATSEC
Examination Access Arrangements, 2015.
•
Students may apply early in February of Form 4.
•
Applications for those sitting for the Matriculation Examinations in September for the first
time must apply by the 15th of June (or before if 15th June falls on a Saturday or Sunday).
L-UNIVERSITA` TA’ MALTA
UNIVERSITY OF MALTA
Form B
Application for Candidates with SpLD and/or ADD/ADHD
Candidate’s Details
ID. Number:
Date of Birth:
Last Name:
First Name:
Condition:
Did the candidate sit for any SEC exams previously?
Yes
No
Please give details if previous examination access arrangements were granted by the ADSC.
Author/s of this report
Last Name:
First Name:
Qualifications:
Warrant No:
Are you a qualified psychologist?
Yes
No
Are you a qualified literacy specialist?
Yes
No
If you have answered NO to the previous questions, please explain how you deem your
qualification(s) to be appropriate for the certification required:
I declare that the contents of this report are accurate:
Date:
Signature:
Examination Access Arrangements Requested:
Room with a few students
Extra Time
Reader
Word Processor
Other, please specify
55
Prompter
Supervised rest breaks
Please
provide a summary of the outcome of the psych
SpLD/Dyslexia
Section
Please provide a summary of the outcome
of the psycho-educational
assessment and state
the date when it was undertaken:
the date when
it was undertaken:
Candidate’s
Cognitive
Profile (fill in scores where relevant)
Year
IQ/GCA
Verbal
Performance
Non Verbal
Spatial
Other
SpLD/Dyslexia Section
Candidate’s Cognitive Profile (fill in scores where relevant)
Year provide
IQ/GCA
Performance
Non Verbal Spatial
Otherand state
Please
a summaryVerbal
of the outcome
of the psycho-educational
assessment
Literacy Update Scores (Complete if applicable)
the
date
when
it
was
undertaken:
Literacy Update Scores (Complete if applicable)
English Reading Comprehension Test
(Suffolk)
English Reading Comprehension Test
(Suffolk)
Please provide a summary of the outcome of the psycho-educational assessment and state
Date
the date when it was undertaken:
Date
Standard
Score
Reading
Age Scores (Complete if applicable)
Literacy
Update
English Reading Comprehension Test
(Suffolk)
Maltese Reading Comprehension Test
Literacy
Scores (Complete if applicable)
(Naqra Update
u Nifhem)
Date
DateReading Comprehension Test
English
Standard
(Suffolk)
Standard
Score
Maltese
Reading
Comprehension Test
Reading
Age
Spelling
Tests
English
Maltese
NARA (Complete if applicable)
Standard
Date
Score
Reading Speed
wpmReading
AgeRate Age
Reading
Comprehension
Age
Accuracy Age
Standard
Score
Reading
Age
Spelling
Tests
Maltese
Speed of Writing Test (Complete if applicable)
NARA (Complete
if applicable)
Spelling
Tests
Maltese
Patoss
Date
Writing speed
wpm
Standard score
Reading Rate Age
Reading
Comprehension
Age
Age
Accuracy Age
Speed of Writing Test (Complete if applicable)
Patoss
Hedderley
Date
Writing speed
wpm
Standard score
Date
Spelling Tests
(Naqra u Nifhem)
English
Maltese
Date
Maltese
Reading Comprehension Test
Standard
Standard
(Naqra
u Nifhem)
Score
Score
Reading
Date
Reading
Age
Age
Standard
English
Score
Date
Reading
Reading Speed
Standard
wpm
Age
Score
Maltese Reading Comprehension Test
(Naqra u Nifhem)
Standard
Score
Reading Age
Standard
Score
Score Age
Reading
Date
Reading Age
English
Standard
Score
Reading Age
56
Hedderley
ADD/ADHD Section (complete if applicable and attach the summary score sheet)
Continuous Performance Scores Test Date:
IVA+
Conners CPT
Full Score
RCQ
AQ
SAQ
Other:
Auditory
Score
Visual
Score
Inattentiveness
Impulsivity
Sustained Attention
Vigilance
Scores
Conners Parents/ Teachers Scales (fill in where relevant)
Please attach a copy of the summary score sheet Date:
Oppositional
Cognitive/Inattention
Hyperactivity
ADHD Index
Parent Scale T-Score
Teacher Scale T-Score
Qualitative Analysis (If applicable)
____________________________________________________________________________________
For Official Use Only:
Date of Application Received
Date of Application Discussed
Comments
Decision
57