Exam Information Form
This form should be completed by the instructor and returned to Disability Services prior to the test date.
Student: ______________________________ Course: ___________________ Instructor: ________________________
Testing Date(s):_________________________________ Testing Time: ____________________________
Amount of time allowed for class exam including accommodation time: _________________________________________
The students may use the following materials during testing (check all that apply):
Calculator Textbook Class Notes
Dictionary Graphs Lab Book
Thesaurus Formula Sheet Other _________________
Students will record answers on (check one):
Test Copy Scantron Answer Sheet
Instructor would like to (check one):
Pick Up Completed Exam Receive Scanned Copy of Completed Exam by Email
Instructors may pick up the completed exam at the front desk, Wynn 1209. ext.1409.
*Please inform your student prior to testing date of any special material(s) that needs to be returned (i.e. notes, scratch
paper, or other). The Disability Services office will only collect what the student places in the return envelope.
For Disability Services to Complete
If you have questions about testing accommodations please contact Disability Services at 919-536-7207 ext. 1409.
Appointment Time:
Appointment Date:
Arrival Time:
Begin Test Time:
End Test Time:
Revised 2/2016