Learning Center Accommodative Testing Form


Date of Test:
Time of test:
Student Name:
Course:
Instructor:
Instructor email:
Office Location:
Extension:
Date Class Taking Test:
Time Class Taking Test:
Allowed Time For Test:
METHOD OF EXAM DELIVERY
TO Learning Center
Instructor will deliver
Student will deliver
Instructor will e-mail
(click on this link to e-mail test)
METHOD OF EXAM RETURN
TO INSTRUCTOR
Instructor picks up
Student returns test
Learning Center returns test

PLEASE CHECK YES OR NO: `
  YES NO
Notes allowed
Open book
Calculator allowed
Dictionary allowed
Scrap paper allowed
SPECIAL INSTRUCTIONS
AND COMMENTS :