Alternative Testing Request

Complete the following contact information.

Please Note: Disability Services uses NTC email as its primary mode of communication.

First Name* 

Last Name* 

Student ID Number* 

9 Digit Number
NTC Email*
Primary Phone 

Secondary Phone 


Complete the Test Room Request Information

Hours: Typical DS Accommodation Testing Center hours are Monday - Friday, 7:30 AM to 5:00 PM



Instructor Email*
Is this On-line?* 
Test 1 Name* 

Test 1 Date* 
Date Picker
Test 1 Starting Time 

Test 2 Name 

Test 2 Date 
Date Picker
Test 2 Starting Time 

Test 3 Name 

Test 3 Date 
Date Picker
Test 3 Starting Time 

Test 4 Name 

Test 4 Date 
Date Picker
Test 4 Starting Time 

Test 5 Name 

Test 5 Date 
Date Picker
Test 5 Starting Time 

Test 6 Name 

Test 6 Date 
Date Picker
Test 6 Starting Time 

Additional Exam Dates:
If you have multiple exams in the same course this semester, please fill out their exam dates below.

Please Note: Unless indicated by your instructor, or you have an approved conflict, your test will begin at the scheduled time.

If you do not show up for your appointed time you may not test until new arrangements are made with your instructor.

Your request must be received no later than 3 SCHOOL DAYS prior to the test, or Testing Accommodations may be denied.


Approved Accommodations Request

Check only accommodations approved by DS Staff, listed in your Student Accommodation Plan and Card

Test Adaption's 

If you have any questions or comments regarding this form, please contact:

Disability Services


I understand it is my responsibility to arrive on time and begin scheduled test.* 
I understand testing staff are required to report any suspected evidence of cheating to the instructor and the Director of Student Success.* 
I understand it is my responsibility to schedule the exam during Testing hours: Monday to Friday 7:30 to 5:00 Note: Testing must be completed by 5:00 - take in consideration your extended time* 
I understand it is my responsibility to make arrangements with my instructor, then the testing center to reschedule any tests. The instructor must approve this first.* 
I understand it is my responsibility to complete this form 3 school days prior to the test.* 
I understand it is my responsibility to follow all proctoring instructions presented to them by testing administrators received from the instructor.* 
The following items may not be used while testing (unless specifically directed by instructor) phones, calculators, books or notes and should not be used in testing areas. Hats and jackets should be taken off.* 
I understand that I may be scheduled to test in a reduced distraction area, not a private room. I may be contacted to reschedule my test if all areas are unavailable so I will monitor my NTC e-mail account. Note: please be sure to schedule your tests early.* 

Testing Room Agreement