Alternate Test Request Form

Students are required to submit the form below at least two (2) business days in advance so that arrangements can be made for a proctor, the use of any software, and for the test to be sent to the alternate testing staff.

Name:(Required)

First Last

Best Phone Number to reach you:(Required)

Best Email to reach you:(Required)

Course Number and Section Number:(Required)

Name of Course:(Required)

Instructors Name:(Required)

Date your class is scheduled to take the test:(Required)

Time your class is scheduled to start the test:(Required)

Date and time span that you are requesting to take the test:(Required)

Factor in double time if needed.

Additional accommodation needs?

ex. reading software, JAWs, speech to text software, etc.

THIS PORTION IS FOR INSTRUCTOR USE ONLY:

Are there any special instructions for proctoring this test?

(ex. Open textbook, bubble sheets, use of calculator, need for specifice sofware, etc.)

Are you agreeable to the time that the student is requesting to start the test?

Start time may be different than the planned start time for the class?

Yes

How will you be delivering the test to the Alternate Testing Area?

Digitally

Hard Copy

How would you like the test returned to you?

Digitally

Hard Copy

Is there a best way to reach you during the test if there are any questions?

Admissions

Let us take the mystery out of the enrollment process.

Alternate Test Request Form