Is this request 3 business days in advance of your exam? If not, please note that your request may not be able to be accommodated by LAS.
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Yes
No
In general, we encourage students to reach out to professors a week ahead of any exam to see if they can provide testing accommodations within their department(s) prior to requesting proctoring from LAS. Have you communicated with your professor about arrangements for this exam?
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Yes
No
Name
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First Name
Last Name
Student E-mail
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Professor's Full Name
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First Name
Last Name
Professor's email
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example@example.com
Course Name and Number (Ex. ECON 211)
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Exam Format: Check all that apply
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Paper and Pencil Exam
Computer Based Exam
Other
If format is other, please specify
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Requested Date: You are required to take the exam at the same day/time as the class unless you have the permission of the instructor to take the exam at an alternate time
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-
Month
-
Day
Year
Date
Requested Exam Start Time: You are required to take the exam at the same day/time as the class unless you have the permission of the instructor to take the exam at an alternate time
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1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
05
10
15
20
25
30
35
40
45
50
55
Minutes
AM
PM
AM/PM Option
If you are requesting a different day and/or time than the rest of your class, please indicate the reason why:
How long is the exam (standard time for all students)?:
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Approved LAS testing accommodations that you plan to use for this specific exam:
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1.5 Extended Time
2x Extended Time
Distraction-reduced environment
Use of a laptop for essay portion
Write directly on test instead of scantron
Test Reader
Scribe
Other
Additional notes:
We have a new LAS Test Proctor Request Form!
Please go here and bookmark it: https://forms.gle/dPAJFuKJkjkLVL2F9
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