Test Information and Adjustment Form
Please complete all the information below to schedule your test or quiz in the Office of Disability Services.
Your information must be ACCURATE since this form will generate an email to your instructor.
Call 372-6119 with any questions.

Student First Name
Student Last Name
T Number
(e.g. T00012345)
Student Phone Number
(e.g. 931-372-9999)
Full Student Email
(e.g. imstudent42@students.tntech.edu)
Instructor Name
Be accurate
Full Instructor Email
(e.g. JDoe@tntech.edu) People Finder
Include course name and number
Date of Classroom Exam
(e.g. 05/01/2014)
Time of Classrom Exam including AM or PM
(e.g. 10:00 AM)
Testing Date in the Office of Disability Services
Must be the same date as the classroom test date.
Testing Start Time in the Office of Disability Services
Please enter a time between 8:00 AM and 11:00 AM OR between 1:00 PM and 3:30 PM.
Time given for test in minutes in the regular classroom
(Enter only a number, like 55 or 80)
Accomodations approved by ODS for your test or quiz:
Check all that apply.