Drew University

Self-Identification Form

Student Name: *

Student ID #:

Email address *

Phone Number *

Home Address *

Date of Birth *

What semester do you plan to attend Drew? [Please indicate: Spring/Fall/Summer, Year] *

Nature of Disability *

Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder

Learning Disability

Mobility Impairment

Blind/Low Vision/Visual Impairment

Deaf/Hearing Impairment

Psychiatric/Mental Health

Health Impairment/Chronic Medical Condition

Traumatic Brain Injury

Autism/Asperger Spectrum Disorder

Other

If other, please describe nature of disability:

What accommodations have you previously used?

What accommodations are you seeking at Drew?

Note: Supporting data is required to receive academic accommodations. If you have questions about what is required, please refer to the documentation guidelines at www.drew.edu/academicservices/disabilityservices/documentation-guidelines

Maximum upload size: 8.19MB

Upload files here with supporting data.

If you are human, leave this field blank.

Release of Information

Housing Accommodation Request Form

Note-Taking Request Form

Note-taking Request Form

Exam Proctoring Request Form (Completed by Student)

Procedures for Arranging Test Accommodations at the Office of Accessibility Resources

The Office of Accessibility Resources (OAR) will provide alternative testing arrangements for students whose disabilities necessitate this accommodation, and whose professors are unable to accommodate them due to restrictions of time and space.  In order to take your test at OAR, you must follow these guidelines:

•	A Testing Accommodation Request Form must be submitted no later than three (3) working days before the test date.  OAR encourages the scheduling of tests with ample advance notice – three days is just the minimum!  The proper notice assures the smooth delivery of accommodations.   
        Test requests are not processed over the weekend; therefore, if you have a Monday test, you must submit the request form no later than Thursday of the preceding week.

•	The OAR Proctoring Center hours are Monday - Friday 9:00 AM - 4:30 PM.  If you have a scheduling conflict or evening class, you must inform your instructor and negotiate an alternate date for the exam.

•	 When the Proctoring Center receives a test request, it will be processed and notification will be sent to both the student and instructor.  If you do NOT receive a confirmation email within one business day of your request, please email proctor@drew.edu to confirm your place on the schedule and eliminate the possibility of error.

•	On the date and time of the test, you must first check-in with the exam proctor in BC 119C.  Any student arriving more than 15 minutes late will have to reschedule their test.  All belongings (backpacks, books, purses, cell phones, electronic watches, etc.) must be left with the OAR staff until you have completed your test.  
         
         Bring any special supplies necessary for your exams.  This includes calculators, rulers or equipment specific to the class.

•	The testing room will be monitored by live video camera.  This is to ensure the integrity of the test is upheld in accordance with the University’s Academic Integrity Policy.

The preceding procedure must be followed for each test you take at the OAR Proctoring Center. These guidelines must be adhered to in order for the OAR to effectively provide testing accommodations.

Your Drew email address: *

Name (First and Last): *

Phone Number: *

Instructor First Name: *

Instructor Last Name: *

Instructor Email *

Course Name and Number (example, PSYC 101): *

Date YOU are requesting to take the exam (example, Tuesday, October 12th): *

Time YOU are requesting to take the exam (example, 12:00 PM): *

Date the class is scheduled to take the exam (example, Tuesday, October 12th): *

Time the class is scheduled to take the exam (example, 12:00 PM): *

How long does the class have to take the exam (example, 75 minutes): *

Accommodations you plan to use: *

Distraction Reduced Environment

Extended Time

Calculator

Computer

Large Print

Scribe

Reader

Text-to-speech software/speech-to-text software

Voice Recognition Software

OtherOther

Special Notes:

If you are human, leave this field blank.

Drew

Connect With Us

Resources

Accessibility Resources

Forms

Self-Identification Form

Release of Information

Housing Accommodation Request Form

Note-Taking Request Form

Exam Proctoring Request Form (Completed by Student)

Parking Exception Request Form

Dietary Modification Request Form

Alternative Text Request Form