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| Test Accommodation Request Form - Student Portion |
DRC Test Request Timelines Using alternate media (Kurzweil, enlarged text, etc) or a reader or scribe? If so, please make your request at least 5 working days before the test.
For all other tests, please make your request at least 1 working day before your test. |
| 1. |
Your contact information
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| 2. |
G# ✱
Example: G0000006 |
| 3. |
Course Information ✱
Example: DSKL 825.1 Lariviere |
| 4. |
In class test date ✱
What day will the class be taking the test?
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An answer is requiredValue out of range | |
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| 5. |
In-class test start time ✱
example - 11:00am |
| 6. |
Date you are requesting to take the test, if different from in-class test date.
Your instructor must approve your alternate test date and time request. Please have your instructor confirm alternate date and time with the DRC via the instructor form.
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An answer is requiredValue out of range | |
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| 7. |
If you are requesting to take the test on a different date, what time would you like to take the test?
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| 8. |
Approved accommodations requested on this exam ✱
Accommodations will be verified by the DRC
Please select {0} response(s)
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| 9. |
I authorize DRC staff members to discuss issues related to the accommodation(s) requested with my instructor. I have read the test guidelines located on the DRC website and acknowledge my understanding of them. I understand it is my responsibility to follow up with my instructor to confirm that test information has been sent to the DRC. I understand it is my responsibility to follow up with the DRC to confirm that my test appointment has been set.
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Please select {0} response(s)
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