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Exam Accommodation Request Form - Summer 2025
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***This form is for Emory College courses only***
OUE Accommodated Testing Services (ACTS) will proctor in-person exams for students in ECAS courses with Department of Accessibility Services (DAS) accommodations.
Important Notes for Instructors:
Exam requests must be made at least one (1) business week in advance.
Exams must be delivered to OUE (either via email or in-person) at least 48 business hours prior to the exam date/time.
If you have any questions, please email OUE ACTS at
[email protected]
.
Instructor and Course information
Instructor Name
Instructor Email
Course Number and Section
Course Title
Contact Information:
Should the proctor need to contact you during the exam session with a time-sensitive question (e.g., digital exam access code issues), please provide an
immediate
contact method, reachable during non-business hours. If you provide a phone number, please indicate your contact method preference (i.e., call or text, or both).
Any information provided will not be directly shared with students.
It is recommended that instructors monitor their communication for a few minutes after the exam session start time.
If the proctor does not receive a response within 25 minutes, the student(s) will be rescheduled for another day.
Contact
Exam Instructions
OUE ACTS typically offers Monday-Thursday evening sessions, and during the day on Friday. The testing coordinator will email the instructor and student with scheduling details. OUE will only reschedule exams with instructor permission, as indicated below.
How will the exam be provided to the student?
How will the exam be provided to the student?
I will send the paper exam to
[email protected]
or hand deliver to Candler Library, Suite 200.
Student will take the exam in-person using a personal computer
Exam must be delivered to OUE (either via email or in-person) at least 48 business hours prior to the exam date/time.
All hand delivered exams must be placed inside a sealed and labeled (instructor name, course), manila envelope; and delivered to OUE at least 48 business hours prior to the exam date/time.
What is the original exam date for all students in your course?
What is the original exam date for all students in your course?
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2025
ATTENTION: You cannot submit this form within three (3) days of the Original Exam Date. Please contact
[email protected]
with questions.
What is the original exam time for all students in the class (e.g., 4:00 PM)?
What is the standard exam length? (OUE will calculate extended time based on student accommodation)
What materials may a student bring to or use during the exam?
(If none, please type N/A)
Are there any specific instructions for the exam the proctor team should be aware of?
Student Rescheduling:
When students present time conflicts, do we have your permission to reschedule their exam within a reasonable amount of time? Note that if yes, we will copy you on the final correspondence, but will handle the rescheduling request independently. If no, we will not reschedule students without your written permission.
Student Rescheduling:
When students present time conflicts, do we have your permission to reschedule their exam within a reasonable amount of time? Note that if yes, we will copy you on the final correspondence, but will handle the rescheduling request independently. If no, we will not reschedule students without your written permission.
Yes
No
Exam Return:
Please select how you would like to receive the completed exam:
Exam Return:
Please select how you would like to receive the completed exam:
Paper exam – Please scan and return via email
Paper exam – Instructor or TA will pick-up hard copies from Candler Library 200
Digital exam – Please shred all scrap paper
Digital exam – Instructor or TA will pick-up scrap paper from Candler Library 200
Digital exam – Please scan all scrap paper and return via email
Student Information
Do you have more than five (5) students with DAS accommodations in a single class?
Do you have more than five (5) students with DAS accommodations in a single class?
Yes
No
Student 1
Student First Name
Student Last Name
Student ID Number
Student Email Address
Accommodation(s)
Accommodation(s)
50% Additional Time (Time and a half)
100% Additional Time (Double time)
Reduced Distraction
Private Room
Use of a scribe
Use of a reader
Use of a computer
Natural Light
Other
If Other, please describe the required accommodation.
Do you need to add another student?
Do you need to add another student?
Yes
No
Student 2
Student First Name
Student Last Name
Student ID Number
Student Email Address
Accommodation(s)
Accommodation(s)
50% Additional Time (Time and a half)
100% Additional Time (Double time)
Reduced Distraction
Private Room
Use of a scribe
Use of a reader
Use of a computer
Natural Light
Other
If Other, please describe the required accommodation.
Do you need to add another student?
Do you need to add another student?
Yes
No
Student 3
Student First Name
Student Last Name
Student ID Number
Student Email Address
Accommodation(s)
Accommodation(s)
50% Additional Time (Time and a half)
100% Additional Time (Double time)
Reduced Distraction
Private Room
Use of a scribe
Use of a reader
Use of a computer
Natural Light
Other
If Other, please describe the required accommodation.
Do you need to add another student?
Do you need to add another student?
Yes
No
Student 4
Student First Name
Student Last Name
Student ID Number
Student Email Address
Accommodation(s)
Accommodation(s)
50% Additional Time (Time and a half)
100% Additional Time (Double time)
Reduced Distraction
Private Room
Use of a Scribe
Use of a Reader
Use of a Computer
Natural Light
Other
If Other, please describe the required accommodation.
Do you need to add another student?
Do you need to add another student?
Yes
No
Student 5
Student First Name
Student Last Name
Student ID Number
Student Email Address
Accommodation(s)
Accommodation(s)
50% Additional Time (Time and a half)
100% Additional Time (Double time)
Reduced Distraction
Private Room
Use of a Scribe
Use of a Reader
Use of a Computer
Natural Light
Other
If Other, please describe the required accommodation.
More Than Five Students
To request accommodations for more than five (5) students in a single class, download
this spreadsheet
, insert student information, and upload the spreadsheet below.
Submit
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