A red asterisk * indicates a required field.
Alternative testing arrangements may only be applied to unscheduled test registrations.
Prior to submitting this form:
• Register for the test(s) for which you are requesting accommodations.
• Do not schedule your appointment. If you did schedule a test date, please cancel your appointment before completing and submitting this form.
(Found in your registration account)
Current Characters (Max 500): 0
Current Characters (Max 500): 0
Current Characters (Max 1000): 0
Current Characters (Max 500): 0
I have read the current program website and hereby agree to abide by the conditions set forth, including the Rules of Test Participation, and I certify that I am the person whose name and address appear on this form. I have completed my registration for CASA IBT and submitted correct payment. I am submitting, together with this Alternative Testing Arrangements Request Form, any required documentation as noted on the program website. If my institution is submitting an Institutional Verification of Documentation on my behalf, I authorize that institution to submit a copy of the documentation referenced on that form to Evaluation Systems upon request. I understand that I should submit my request and all necessary documentation as early as possible in advance of my desired test date. I understand and agree that the alternative testing arrangements I have requested herein will be given due consideration. If, and to the extent that, any such request is granted, I understand that I will be taking the test under alternative conditions.
Please check the box below.
Please note, this form must be submitted with each registration.