Accommodated Testing Form

When should I submit my accommodated testing request?

Students Name*
First Last
Student's Email Address*

Please use the student's CFCC email address ending in mail.cfcc.edu
Student's ID Number*
Student's Phone Number*
Instructor's Full Name*
Instructor's Email Address*

Please use the Instructor's CFCC email address.
For a complete list of instructors, check the Faculty Directory
Course Name and Section*
Requested testing date*
MM slash DD slash YYYY
Requested Testing Time*

: Hours

Minutes

AM/PM
My class is located at:*
- Wilmington Campus - Union Station 218
- North Campus - NA 106B
- Burgaw Campus - SAS staff will contact with room number.
- Surf City - SAS staff will contact with room number.
Additional Comments (Optional)

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