Proctor Request Form

  1. Student Support
  2. Office of ACCESSibility
  3. Information for Current Students
  4. Proctor Request Form
Proctor Request Form

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We require at least 7 days notice to guarantee the accommodation.泭

We will still accept late forms and will make every effort to accommodate, we just cannot make any guarantees without a week's notice.泭

Please do not submit forms more than 2 weeks in advance.泭

STUDENT SECTION

Requested Accommodations

Requested Accommodations *
I have read and understand the rules and protocols for using testing services with The Office of ACCESSibility.*

PROFESSOR SECTION

FOR PROFESSORS TO FILL OUT ONLY.泭

STUDENT, DO NOT FILL OUT THIS SECTION.泭

The professor should fill out a hard copy and give it to the student to upload.泭

OR泭

The professor should fill out the digital form below.泭


Click on the link below to download a hard copy of the Professor Section to upload.泭


If your professor filled out the paper version of the Professor Section, please upload it here.
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File uploads may not work on some mobile devices.

Professor Information

Exam Information

Date and time of exam*
: 泭
Will lecture resume after the exam?*

Due to limited hours, it may be necessary to arrange testing at an alternative date/time than the regular class exam.

  • Dobbs Ferry available testing hours: 9 AM5 PM, MonFri or by appointment
  • Bronx and Manhattan by appointment
Please indicate an alternative date and time to take the exam:
: 泭
How will professor deliver exam to ACCESSibility Office? *
How will professor retrieve completed exam? *
Example: calucalator, scratch paper, formula sheet, etc.
Forging this signature will result in conduct sanctions.
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