A red asterisk * indicates a required field.
Alternative testing arrangements may only be applied to unscheduled test registrations.
Prior to submitting this form:
• Review the Alternative Testing Arrangements Permitted in the Online Proctoring section of the website.
• 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.
*
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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 test registration and submitted correct payment. I am submitting, together with this completed 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 the information I provide, including any supporting documentation, may be shared with the Virginia Department of Education in order to process my request. I understand that I should submit my request and all necessary documentation as early as possible in advance of my desired test date. Because of space, staff, and time constraints, I may not be able to schedule a test appointment with accommodations in my preferred date range. 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. I understand that once I have submitted my supporting documentation, those materials will be used by Pearson to process my request and will not be returned to me.
Please check the box below.
Please note, this form must be submitted with each registration.