Instructor's LAST name only.
Be sure this is correct or your instructor will not receive the approval email.
Date & time scheduled for class
How much time has the instructor allotted for the exam?
If you have selected a date sooner than 7 days from now, you must supply the reason for your short notice request. Also, be advised that a testing room may not be available on short notice.
How much longer than the originally allotted exam length do you need? If 'Other' please specify.
Select the aids for which you are qualified. If you select 'Other' please describe your needs in the Comments field below.
Describe any additional requests and comments here.