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Center for Student Progress

 

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Test Request Form

Student's E-mail    Professor's E-mail  Student's Name     Date of Request  Student's ID#    Telephone  Professor's Name    Ext.  Full Class Name    Course Code    CRN #  Test Given in Class:  DAY    DATE    TIME:   FROM   TO ** Accommodations Needed: WHEN I NEED TO TAKE THE TEST AT CSP DISABILITY SERVICES: DAY     DATE    TIME:  FROM     TO   If scheduled different from class time, why?   (Must have Professor's signature or s/he must call the office to give permission.)

** If you do not request your needed accommodations, it may affect our ability to administer your test as scheduled. 

Rev. 08/09

 

Center for Student Progress  •  Kilcawley West  •  Phone: 330.941.3538  •  Fax: 330.941.1455

© 2011 Youngstown State University  •  One University Plaza  •  Youngstown, Ohio 44555

Admissions: 330.941.2000  •  Graduate Admissions: 330.941.3091  •  General Information: 330.941.3000

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