HMC Student Extended Exam Time Request
Exams requiring extra time are taken in the 5C Student Disability Resource Center (SDRC) in Tranquada Student Service Center (1st floor) instead of at HMC. Testing times are available Monday-Friday from 8:30 a.m.-5:00 p.m.

Please note, if your professor offers to proctor your extended or distraction-reduced exam and you are comfortable with that arrangement, you do not need to submit this form.

Please fill out this form so that I will have all the information necessary to schedule your exam in the SDRC. Thank you!

Brandon K. Ice
bice@hmc.edu
Student Disability Resources

Your name: *
Your answer
Professor's Name: *
Your answer
Course (i.e. E59) *
Your answer
Exam or Quiz? *
Date of exam/quiz: *
MM
/
DD
/
YYYY
Scheduled exam/quiz time: *
What time will your class will be taking the exam?
Time
:
Length of exam/quiz (how long the students taking the exam during class will have to complete it): *
This will also be confirmed with your professor.
Hrs
:
Min
:
Sec
Documented accommodation/s requested for this exam: *
Check all that apply
Required
Do you have a class scheduled immediately following your exam/quiz that would prevent you from receiving extra time for your exam? *
If you do have a class immediately following your exam/quiz, do you have availability to begin the exam/quiz before your scheduled class time?
If you do have a class immediately following your exam/quiz, do you have availability to begin the exam/quiz later in the day?
By signing my name below, I confirm that I have discussed taking this exam/quiz in the SDRC with my professor. *
If not, I will discuss the exam/quiz with my professor as soon as possible.
Your answer
Please read the following SDRC guidelines and indicate your understanding and agreement to the guidelines below.
SDRC Testing Guidelines
• The SDRC will not assist with Testing Accommodations if the student is not registered with the Disability Coordinator on their home campus for the semester in which accommodations are being requested.

• Accommodations will be verified to ensure that they are currently approved for the student. Our computers are only for those approved for a word processor as an accommodation. Other students may have their own laptops that could be used in class or with the SDRC if approved by faculty.

• Student agrees with their signature that they will comply with the guidelines within this form and those established by the SDRC and their home campus Disability Coordinator. Student also promises that the work performed at the SDRC will be conducted with complete academic honesty with the aim to provide appropriate respect and concern for the test and testing accommodations provided. Any attempts to cheat or abuse academic trust will be reported.

• The SDRC asks that students arriving late have permission from their professor/TA.

• All changes to scheduled exams must be approved by all parties.

• This form is an agreement between the PROFESSOR and STUDENT.
The SDRC will administer exams according to the information established on this form.

By signing my name below, I confirm that I have read the SDRC guidelines and agree to follow them. *
Your answer
Questions? Concerns?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Harvey Mudd College. Report Abuse - Terms of Service - Additional Terms