Lewis University | Testing Center | Oak Brook Exam Request Form

Oak Brook Exam Request Form

Today's Date: 11/12/2024

*Student First Name:

*Student Last Name:

*Student Email:

*Name of the course:

*Instructor First Name:

*Instructor Last Name:

*Date that the class is taking the exam:

*Time that the class is taking the exam:
to
*Date student is requesting to schedule the exam (Must allow 48 business hours in advance):

*Time student is requesting to schedule the exam:
to
*Do you need a computer or technology for this exam?
yes
No

Will you be using a computer or technology for this exam?
I am permitted to use my own laptop for this exam
I must use a test center computer.

What format is the test?
My exam is traditional paper/pencil
My exam is administered with lockdown browser
My exam is administered through ATI

*Please list accommodations you need or any other information you would like to tell us about the exam, other than extended time. Please note: exams that require a reader and/or scribe need to be requested one week in advance to allow for staff scheduling. :

*Please type the word :

Invisible line, width of the page