West Valley College
14000 Fruitvale Avenue, Saratoga, CA 95070 • Phone (408) 867-2200

DESP: Test/Quiz Accommodation Request Form

 

FILL IN FORM AND SUBMIT

All test/quiz requests should be made one week prior to the test/quiz.

asterisk All information must be filled in.

 

Today's Date: / /

 

YOUR CLASS INFORMATION

Class Name:

Instructor's Name:

Type of Exam

TEST QUIZ

Date of Test/Quiz:

/ /

Time of Test/Quiz

: AM PM

Comments:

 

YOUR CONTACT INFORMATION

Your Name:

Your Student ID:

(7 DIGITS)

Your Phone:

( ) - Ext:

Your E-mail:

 

 

 

last published: 8/12/14 • validate xhtml css 508