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.
(As listed 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 completed the registration process for the THEA Internet-Based Test and agree to abide by the conditions set forth on the THEA IBT Web site, including the Rules of Test Participation for the THEA IBT, and I certify that I am the person whose name and address appear on this form. I am submitting, together with this completed Alternative Testing Arrangements Request Form for THEA IBT, any required documentation as noted. 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.