Mt. San Jacinto College

MSJC DSPS Student Test Request

Please fill out the form and click submit. Required fields are marked*.

Please keep in mind of the following TEST REQUEST GUIDELINES:

  1. During the semester if your instructor changes the test/exam/quiz date, YOU are responsible for informing DSPS of the change.
  2. Only for special circumstances, we will take individual test requests.
  3. Make appointments that allow for enough time to complete a test/exam/quiz with extended time considering DSPS hours of operation and your other scheduled responsibilities.
  4. Schedule AND take your test/exam/quiz on the same day & time as your class and complete the test/exam/quiz in one sitting. ***Exceptions to this must be approved by the class instructor.
  5. Arrive on or before the scheduled test/exam/quiz time. If you are late, that time will be counted as part of your test/exam/quiz time. Just as it would if you were late to class on test/exam/quiz day.
  6. Take care of personal needs prior to starting exams (bathroom, using cell phone, etc.).
  7. Contact DSPS AND your instructor if you are unable to take your test/exam/quiz on the scheduled day and time for any reason.
    • If you miss your test/exam/quiz, it will be returned to your instructor. It is up to you to see if the instructor will allow a make-up test/exam/quiz. If your instructor approves, a new Student Test Request Form will need to be submitted.
  8. You MUST contact DSPS if a test/exam/quiz date/time changes and/or you drop a class.

Student Information

*Student's First and Last Name:

*MSJC Student ID Number:

Student Email ends with

*Best Contact Phone:

Course Information

*Instructor Name:

*Course Name:

*Section Number:

*Test DATE (must be the same date the class is taking the test, otherwise a letter of approval from the instructor is needed):

*Test TIME (must be during hours of Monday Thursday 8am-3pm or Fridays 8am 10am):

*Title of the exam, test or quiz being requested:

Based upon your approved accommodations, please select which additional services you will need to complete this request in the DSPS office: