DSS Test Request Form
Before proceeding, please read and agree to the below statements.
*
If the request is outside of my normal class day and/or time, I must have the professor's permission before scheduling
I am scheduling at least 3 business days in advance
The DSS has approved my testing accommodations
I have allowed enough time, based on my accommodations, to be finished by 5pm
Name
*
First
Last
Email
*
Phone
*
-
Area Code
-
Prefix
Line Number
Testing Details
Date of test
*
/
MM
/
DD
YYYY
Time of test
*
:
HH
MM
AM
PM
AM/PM
Must finish by 5pm, excluding final exams week
Class name
*
example: MATH-M 107
example: MATH-M 107
Professor's Name
*
First
Last
Professor's Email
*
Professor has the right to approve or disapprove any start times.
If you are rescheduling an exam, please indicate below. You can also email our office at sbdss@iusb.edu, or call 574-520-4460.
If there are any materials you are allowed to use on your quiz/exam, including
computer access, please mention below. If you have any questions or comments, please also indicate in the field below.
*