Proctor Instructions for Testing Accommodations
Peer Consultation ext. 3404 or ext. 3233
peerconsultation@berea.edu
The purpose of this form is to ensure that your student has all of the tools necessary to do well on
his or her exam. Please be sure to discuss accommodations with your student and check the
appropriate items below. Send to Peer Consultation at least two (2) days before the exam.
Student’s Name _____________________________ Professor _____________________
Class ___________________ In-class Exam Time (start-finish) _____________________
Check List for Testing Room Permissions Please mark an X beside the agreed upon testing
procedure guidelines that you are authorizing for this exam:
[ ] Peer Consultant may paraphrase
questions
[ ] Additional Resources are permitted
(book, notecard, etc.)
Please Specify:
[ ] Calculator is permitted
Type: ________________
[ ] Computer program will be
used
________________________
________________________
[ ] Computer may be used
(to type essays)
Other Special Instructions:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Will these same guidelines be used for all exams this semester?
[ ] Yes
[ ] No (If no, a new form must be submitted at least two (2) days prior to each test)
[ ] Some modifications may be made (i.e. Time allotted, calculator)
Professor Signature:
______________________________________________ (date) __________________
Phone (to reach professor during the exam):
Peer Consultation | Center for Transformative Learning | Stephenson Hall, Room 314