Undergraduate Exam Request Form
Please fill out the form to request the Office of Student Accessibility proctor exams for the courses indicated. Finals Exams: See our website for additional information on how to schedule your exams.

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Email *
Your Preferred First and Last Name *
Are you an undergraduate student? *
Did you notify your professor of your plans for our office to proctor these exam(s)?  *
Exam and Quiz Reservations (complete this form 5-7 days in advance)

Late Exam Reservation:  2 days before an exam by 12:00 pm, (or 12:00 pm on Thursday for Monday exams). Exams scheduled after this Noon deadline two days before an exam will be cancelled and you will need to take it with the class without your exam accommodations.  Do not complete this form. Email access@lclark.edu if you have any questions.
FINAL EXAMS: Reservation deadline is typically 14 days before the first day of finals. Please make your exam reservations early.  Proctoring is not available during reading days or on the weekends for Spring semester
Class Abbreviation: (ex: ART, BIO, CHEM, CORE) *
Class Number (ex: 100, 105, 200) *
Instructor's First and Last Name *
Date you are taking the Exam *
MM
/
DD
/
YYYY
What time will your class begin the exam?
Time
:
How long will the class have to complete the exam? *
Hrs
:
Min
:
Sec
What time will you start your exam in the Office of Student Accessibility? Start time should be the same as the class start time* *
*Please schedule your exam on the same date and time as the class (we assume you may start extended time earlier to finish at the same time as the class). All other times must have preapproval from the professor. Flexibility accommodations do not typically apply to exams.
Time
:
How much extended time do you receive? *
(As indicated on your Notice/Letter of Accommodations)
As indicated on your signed Notice/Letter of Accommodations, what accommodations would you like to use for this specific exam?
Any other additional comments or requests about this exam? See below examples.
  • bringing own laptop to access notes or take an online exam
  • quiz
  • specific testing space needs
  • starting exam with the class, will come to OSA for extended time only
  • information regarding why you are starting exam at a different date or time. (make up exam, have conflicting classes before and after this class, etc.)
  • Start time different than the class? Please let us know the professor approved the change in exam start time. If you do not mention professors approval to change the exam start time, the exam may revert to the class start time.
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