Office of Student Accommodations
Testing Cover Sheet
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*Instructor Emplid: *Name: *Email:
*Office Phone: *Cell Phone: (format 999-999-9999)
*Student Emplid: *Student Name:   
*Student's Phone: *Student's Email:
*Division: *Campus:
Testing Instructions
Please check all that apply. Please be as detailed as possible in your directions.

  *Last date test to be administered
        Pick a date (mm/dd/yyyy)

Answer Sheet     

  *Write on test:  

Return Extended Time        (Extended Time option required)

  *Test Allocated Time:   

Student will have   to complete this test.

Additional Directions:

If you would like to submit an electronic copy of the student's test, please save the test to our Sharepoint site.