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Proctor Request Form

It is your responsibility to complete this form at least 7 days prior to the requested exam date to guarantee your accommodations.

(*Required field)

Student Information
Requested Accommodations

Please indicate which accommodations you have been approved for and are requesting for this exam:

Instructor & Exam Information

Please consult your professor to complete this section. Information will be verified by your professor prior to exam.

Exam Information

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 AM–5 PM, Mon–Fri; Some weekends available
  • Bronx, Manhattan, Yorktown Heights Available Testing Hours: Please consult Office of ACCESSibility

If extended exam time conflicts with the student’s schedule and/or available testing office hours-