Student's Test Accommodation Request

If you need assistance filling out this form, see the secretary.
This request must be made at least 3-5 school days before the test.
You must inform your instructor that you will need testing accommodations so they can fill out an Instructor's Test Accommodation Form online.

*First Name:

*Last Name:

Middle Initial:

*Course Test is Given in:

*Instructor's First and Last Name:

*Days and Time of Class

*Date You are Requesting to Take Your Test:

*Time You are Requesting to Take Your Test:

Note: Please call the Student Success Center at 417-659-3725 with questions.

Accommodations you will need for this test, (accommodations must agree with Accommodation Memo). Check all that apply:

Extended Time

Audio Formatted Test

Computer for Word Processing

Someone to Record My Answers

Reduced Distraction Testing Room

Test Enlarged

Someone to Read the Test Questions to Me

Other

Please Specify:

Sign with MSSU Username and Password

Username

Password