Parkland College

ACCESSIBILITY SERVICES: Alternate Testing Appointment

Name

Student Email

Student ID

DayPhone

Class (i.e. HIS 105-003)

Instructor

Desired appointment day AND time

First Choice

Second Choice

I will need a reader/scribe for this test. Yes No

Submission of this form does not constitute approval of an appointment for alternate testing. You will be contacted by an ODS staff member regarding your appointment.