July 16, 2026 CLT Accommodations

July 16, 2026 CLT Examination Accommodations Request
Student First Name:
Student Last Name:
Student ID Number (ex. 530XXXXXXX)
Student Date of Birth:

MonthDayYear
Date
The student will be taking the CLT at Lake Wales High School on July 16, 2026.
Does the student have IEP, 504, or English Language Learner Accomodations?
If you are a student requesting accommodations on a CLT exam, please submit this form authorizing your school to release necessary documentation to Classic Learning Initiatives.
Please select the school name:
School's City, State, & Zip Code
Signature of Student and Parent/Guardian
I verify that the information submitted is accurate. I am requesting testing accommodations or English Language Learner supports on the Classic Learning Test. I grant permission to my school to: release to Classic Learning Initiatives, the parent company of Classic Learning Test, copies of my records which document the existence of my disability or status as an English Language Learner and the need for one or more testing accommodations. I also grant Classic Learning Initiatives permission to receive and review my records, and to discuss my disability and needs with school personnel and other professionals. I understand that if this application for accommodations cannot be approved, that the student may be required to test without the requested accommodations.
Student Signature:
Date:

MonthDayYear
Date
Parent/Guardian Signature:
Date:

MonthDayYear
Date
(Both the student and parent/guardian must sign if the student is under 18 years old.
Only the student must sign if the student is over 18 years old.)
Updated 5/27/26
Should be Empty:

July 16, 2026 CLT Examination Accommodations Request

Signature of Student and Parent/Guardian