MSU - Disability Services

Testing Accommodation Requests

Complete the form.

Please note the Disability Service Office will continue to use the NCR TESTING ACCOMMODATION FORM. Pick up your NCR forms at the Disability Service Office, South Entrance - Lower Level, Lura Manor. Please allow DS up to two business days for your NCR TESTING ACCOMMODATION forms to be ready.

Student Name:

MSU ID #:

Class 1 Class:
Test format: Online test Face-to-face
Extended time: 1-1.5 time Double time
Reader needed: Yes No
Scribe or Word Processor: Scribe Use of a word processor
Distraction Reduced Environment: Testing Room Alone

Class 2 Class:
Test format: Online test Face-to-face
Extended time: 1-1.5 time Double time
Reader needed: Yes No
Scribe or Word Processor: Scribe Use of a word processor
Distraction Reduced Environment: Testing Room Alone

Class 3 Class:
Test format: Online test Face-to-face
Extended time: 1-1.5 time Double time
Reader needed: Yes No
Scribe or Word Processor: Scribe Use of a word processor
Distraction Reduced Environment: Testing Room Alone

Class 4 Class:
Test format: Online test Face-to-face
Extended time: 1-1.5 time Double time
Reader needed: Yes No
Scribe or Word Processor: Scribe Use of a word processor
Distraction Reduced Environment: Testing Room Alone

Class 5 Class:
Test format: Online test Face-to-face
Extended time: 1-1.5 time Double time
Reader needed: Yes No
Scribe or Word Processor: Scribe Use of a word processor
Distraction Reduced Environment: Testing Room Alone

Class 6 Class:
Test format: Online test Face-to-face
Extended time: 1-1.5 time Double time
Reader needed: Yes No
Scribe or Word Processor: Scribe Use of a word processor
Distraction Reduced Environment: Testing Room Alone

Please read each statement and check the box.

I am responsible to meet with my instructor to complete Section IV of the TESTING ACCOMMODATION FORM.

I will give the instructor the canary copy; and keep the pink copy. The completed white copy will be returned to DSO as soon as possible. Students not on campus will receive their copies via email.

I will schedule my testing appointments a minimum of 3 days prior to the exam. Call either Ms. Melanie Moore at 701-858-4233 or 701-858-3371. Bismarck students contact Ms. Bobbie Jo Zueger at 701-224-5496.

I will be on time for my testing appointment.

I understand if I am more than 15 minutes late, the exam will be returned to the instructor. I will need to contact the instructor to seek permission to reschedule the exam.