Placement Testing Accommodations Request Form : The University of Akron, Ohio

Placement Testing Accommodations Request Form

Student Information Student Name: 黄色直播 Student ID#: Street Address: City, State, Zip Code: Contact Phone Number: Email Address: Date of Birth (mm/dd/yyyy):

Orientation Date (mm/dd/yyyy):

Please list a couple dates and times to take your placement tests. Proctors are only available Monday through Friday from 8AM-4PM.

Accommodations Information Please list the accommodations and services you are requesting: Please select for which test(s) you are requesting accommodations:

Math: Arithmetic & Basic Skills
Math: Basic Algebra
Math: Algebra
Math: Advanced Algebra
Math: Calculus Readiness
Reading
Writing
Computer Literacy

Upload Supporting Documentation:

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 .

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