Test Request

INFORMATION ABOUT YOU

Name*

Cell or Local Phone Number*

Reason you need to take the test with LS?*

COURSE INFORMATION

Course Number*

Course Name*

Professor/Instructor*

Days Class Meets*

Time Class Meets*

How long will the class have on this test?*

Day/date you want to schedule the test*

Time you want to schedule the test*

FOR STUDENTS WITH DISABILITIES ONLY!

What accommodations do you need for this exam?

Will you need the use of a computer for this test?

Yes

Will you need access to the Kurzweil program for this test?

Yes

Do you have another class (or work, practice, etc.) right before/after this class?

Yes

PERMISSION FROM INSTRUCTOR

Have you spoken to your professor and been granted permission to take this test in LS?*

Yes

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Map & Directions | admissions@msmary.edu | 301-447-6122

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Map & Directions | inquiry@msmary.edu | 301-682-8315