Request for Exam ADA Special Accommodations

Request for Exam ADA Special Accommodations

If you have a disability covered by a national disabilities program (e.g., Americans with Disabilities Act), and you wish to request an accommodation for a qualified disability, please complete this form and the Documentation of Disability-Related Needs sheet so your request can be processed efficiently. The information you provide and any documentation regarding your disability will be treated with strict confidentiality.
Date*

MonthDayYear
Date
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
I am requesting special accommodations for the:*

Certified Construction Manger Examination (CCM)Certified Associate Construction Manager Examination (CACM)Construction Manager-in-Training Examination (CMIT Level 1-4)
Please provide (check all that apply):*

Accessible testing siteSpecial seatingReaderExtended testing time (time and a half)Separate testing areaOther
Details of Request*
Please give us as much information you can regarding the reasoning behind the request
V3.5: 11282023