FORM 7: CERTIFICATION OF ACCOMMODATIONS
HISTORY
NOTICE TO THE OFFICIAL COMPLETING THIS FORM:
Please print or type your responses to the questions below. Return this completed form to the
applicant for submission to the Board.
1. State the following:
Name
Title
Name of the testing agency or educational institution for which you are completing this form:
Address of the testing agency or educational institution:
2. On what dates and in what course of study (e.g., elementary, high school, college, law
school) or testing program (e.g., SAT, ACT, LSAT, MPRE, Bar Exam) was the applicant
NOTICE TO APPLICANT: This section of this form is to be completed by you. The
remainder of the form is to be completed by each educational institution or testing agency
(hereinafter “entity”) from which yo
u have requested accommodations, whether granted or
denied. Please read, complete, and sign below before submitting this form to the entity for
completion of the remainder of the form.
Applicant’s full name:
Applicant’s date of birth: ________________
I give permission to the qualified professional completing this form to release
the information requested on the form, and I request the release of any
additional information regarding my disability or accommodations previously
granted that may be requested by the Massachusetts Board of Bar Examiners
or consultant(s) of the Massachusetts Board of Bar Examiners.
Signature of applicant Date
Massachusetts Board of Bar Examiners
click to sign
signature
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