Accuplacer Accommodations Form

* indicates required field
Student ID *
You must include all 8 digits of your StudentID including the leading zeros.
Full Name
(First, Middle and Last Name)
*
Preferred First Name *
Phone
E-mail address *
Campus
Accommodations
Check all that apply
  1. Paper/Pencil Version
  2. Quiet Area
  3. Auditory Version
  4. Test Scribe
Other Accommodations