Exam/Test Accommodation Request Form Important Guidelines: Please confirm exam dates and times to ensure exam times do not cause a scheduling conflict. Please submit this form at least 2 weeks (14 days) prior to the first scheduled exam. Date Submitted - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Please submit this form at least 2 weeks prior to the first scheduled exam.Student Name * Required First Last Student ID #: * RequiredPlease Enter your 6 digit Michener Student ID NumberMichener Email address * Required Enter Email Confirm Email Academic Program * Required- SelectCardiovascular PerfusionChiropodyDiagnostic CytologyGenetics TechnologyMedical Laboratory ScienceMRINMMITRadiation TherapyRadiological TechnologyRespiratory TherapyUltrasoundOtherCurrent Semester * RequiredFall SemesterWinter SemesterSummer SemesterList of Exams requiring accommodation * RequiredCourse CodeExam DateStart TimeFinish TimeAccommodated Finish TimeFaculty Name Click the little icon on the right to add or remove a row
