Request for Special Examination Accommodations

Request for Special Examination Accommodations
The Texas State Florists' Association (TSFA) provides reasonable examination accommodations to any qualified applicant with a diagnosed physical, mental or developmental disability. Requests and supporting documentation are confidential.

Please submit accommodation requests at least 20 days prior to scheduling a certification exam. TSFA will respond within 10 days after receipt.

If you have any questions, reach out to the TSFA office at 512-528-0806 or email us at tsfaadmin@tsfa.org.
Teacher Information
Teacher Name*

First NameLast Name
School*
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number
Please enter a valid phone number.

Student Information
Student Name*

First NameLast Name
Student Email
example@example.com
What test is this student taking?*

Knowledge BasedIn-Person Level 1In-Person Level 2

Level 1 or 2 Requested Accommodations
Testing Site
What accommodations are you requesting for this student? (check all that apply)

Extended TimeSeparate Testing RoomOther (Specify)

Knowledge Based Requested Accommodations
What day is this student testing?

MonthDayYear
Date
What accommodations are you requesting for this student? (check all that apply)*

Extended TimeOral TestWritten TestOther (Specify)

Supporting Documents
Please upload supporting documents for the requested accommodation(s). Supporting documentation is required for students to receive accommodations.

Cancelof
I affirm that the provided information and any attachments are true and correct. I understand that fraudulent or falsified information could result in the denial of this application. *

Clear
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Teacher Information