Scroll To Top

Placement Testing Accommodations Request Form

Student Information
Accommodations Information
  •   Math: Arithmetic & Basic Skills
  •   Math: Basic Algebra
  •   Math: Algebra
  •   Math: Advanced Algebra
  •   Math: Calculus Readiness
  •   Reading
  •   Writing
  •   Computer Literacy
Electronic Signature Acknowledgement
By checking this box:

I understand that in order to receive reasonable accommodations for my placement exams, I must follow all procedures for scheduling my Placement Testing, complete this request form, and provide documentation of my disability with rationale for requested accommodations. I understand that the information that is provided to the Office of Accessibility (OA) is confidential and that no one outside of the OA will review it.

I agree to receive an email or phone message from the OA regarding approval of my request. In order to preserve confidentiality, I understand the message will not identify the nature of the disability but will address the accommodations approved.

I understand there is a separate process to receive reasonable accommodations. In order to be considered for academic accommodations, I must follow the New Student Application process. For more about this process, visit this website

An asterisk (*) denotes a required field