LEARNING ACCOMMODATIONS TEST SUMMARY FORM

Please complete and submit this form so that we can reserve the appropriate space/resources for the student.




Student name: * 

Professor: * 

Course/Section: * 

Method of test delivery:* 





Method of test return:* 





Phone: 

Email: 

If other was selected, please specify: 

Updated: 1/7/11
Comments  

Earliest date/time test may be given:* 

Latest date/time test may be given:* 

Total minutes allowed for class:* 

Materials allowed for class (check all that apply):