Please fill out the form and click submit. Required fields are marked*.
Please keep in mind of the following TEST REQUEST GUIDELINES:
*Student's First and Last Name:
*MSJC Student ID Number:
Student Email ends with @student.msjc.edu
*Best Contact Phone:
*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:
Other (specify other accommodation in the Message box at the end of the form).
San Jacinto CampusMenifee Valley CampusSan Gorgonio Pass CampusTemecula Education Complex