BRCCACCOMMODATEDTESTING
(TobecompletedbytheinstructorandreturnedtotheTestingCenteroremailedto
testingcenter@mybrcc.edu)
InstructorName:
InstructorEmail:
Course:
StudentName:
TestingDate/Time:
Accommodations: ExtendedTime 
Distraction‐ReducedEnvironment
TestReadAloud 
Scribe
OtherInstructions/Accommodations:

(TCOfficeuseonly)FORAFTERCOMPLETION
DateReceived: 
ExamReceivedBy: 