Student's Test Accommodation Request

If you need assistance filling out this form, see the secretary.
This request must be made at least 48 hours prior to 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 Name:

*Day and Time of Class

*Date and Time of 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

Use CCTV

Other


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