For testing accommodations, please complete the following form for test proctoring. This section is to be completed ONLY by testers who are approved and registered with Disability Services on their home campus and wish to utilize their approved accommodations. The form must be submitted at least three  (3) business days prior to your test. For example, submit MONDAY for a THURSDAY test. For any further questions or concerns, please contact us. 

Student Disability Resource Center
Tranquada Center
(909)607-7419
sdrc@claremont.edu
http://www.claremont.edu/sdrc/
Instagram: sdrc_tccs
Facebook: SDRC Claremont

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* 1. Student's Name

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* 2. ID #

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* 3. Phone Number

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* 4. Email Address

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* 5. Class (Department and Course Number) Ex: SC Math 23-1

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* 6. Your Home Campus

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* 7. Date of Exam

Date / Time

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* 8. Are there any other exams for this course that you would like to schedule with our office? Please list the date and time. THIS COURSE ONLY.

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* 9. Test time-length (For the class; i.e. 75 mins, 3 hrs, etc.)

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* 10. Approved Testing Accommodations

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* 11. Professor's Name

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* 12. Professor's Email Address

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* 13. Is there anything else you would like us to know?

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* 14. By typing my name below, I certify that I have read the above information. Any questions concerning these policies have been discussed. My signature also certifies my understanding of an agreement with the above policies.

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* 15. Today's Date

Date / Time

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* 16. How can we improve our test proctoring services? Please let us know. 

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