Disability Services Test Request Form

This is a request, not a confirmation

First Name:*

MI

Last Name:*

Phone Number:*

Email Address:*

Date of Exam:*

Time of Exam:*

Class (e.g., ENGL 110C): *

Day and Time Class Meets:*

Professor's First Name:*

Professor's Last Name:*

Professor's Phone Number:*

Professor's Email Address:*

Alternative Testing Needs:*

Your request must be submitted at least 3 business days prior to the test date. If you have a Monday exam, it needs to be requested by the previous Thursday.Test administration begins at 8:30 AM Monday - Friday. All tests must be completed by 4:45 PM. Please call (757) 683-4655 with questions or to cancel a scheduled test administration.

Maintained by:� Disability Services Webmaster ��Updated:� 06/3/09 ��|�� 2006 Old Dominion University, Norfolk, VA 23529��|��Privacy