Exam Support Request Form

Faculty Member Name:

What is the date of the exam?

Format: mm/dd/yyyy

Location of exam

Which building?

Which room number?

At what time does your exam start (in 24hr time format)?

NOTE: Make sure you select the minutes as well!!

Please complete all parts of the date.

At what time does your exam end (in 24hr time format)?

Please complete all parts of the date.

What is the full course code (e.g. IDST 1013 X1)?

What is the approximate # of students who will be there?

Only numbers may be entered in this field.

Your answer

When do you require assistance?

For the full exam.

Only at the beginning (specify time period).

Only at the end (specify time period).

Please enter your comment here:

What type of support do you require?

Please select at least one answer

ACORN

Data Projector

Other:

Do you have any students writing at Disability Access or anywhere else other than the classroom?

Yes No

If you have any other information we would require, please enter it here.

Your answer