EmailMe Form - Exam Accommodation Request

Name *

First Last

Need Reader? *

Yes

No

Need Scribe? *

Yes

No

Email *

Student Cell Phone *

### - ### - ####

Course Code *

Instructor Name *

First Last

Reason for Accommodation *

Preferred Exam Date *

MM / DD / YYYY

Preferred Exam Time *

HH : MM AM/PM

Exams start on the quarter hour. Please request your start time appropriately.

Academic Resource Center Testing Policy

1. Test requests must be received two business days prior to the requested exam date and time.
2. This request is not a guarantee. Requests submitted late will be denied and require the student to submit a new request.
3. If a test confirmation email is not received by the student within one business day, the student should contact the Academic Resource Center at 319-352-8615.

Check this box to confirm: *

I acknowledge that I have read, understand, and agree to abide by the Academic Resource Center Testing Policy as it was explained to me in my accommodations meeting and reiterated here.

Wartburg Honor Code

Students, faculty, and staff of Wartburg College are expected to demonstrate integrity in all endeavors. Students are expected to adhere to four essential principles:

1. Submit only original work and properly cite ideas of others, including fellow students.
2. Refrain from giving or receiving unauthorized aide on examinations and assignments.
3. Report any act that violates these principles.
4. Ask for clarification if uncertain about the expectations on a particular assignment.
Students are responsible for abiding by these principles and opposing academic dishonesty in all academic endeavors.

Check this box to confirm: *

I acknowledge that I have read, understand, and agree to abide by the terms of the Wartburg Honor Code.