Disability Resource Center
(405) 325-3852 or Fax (405) 325-4491
PLEASE COMPLETE THIS FORM AND INCLUDE WITH EACH EXAM
STUDENT'S NAME
DEPT / CLASS / SECTION
INSTRUCTOR'S NAME
AUTHORIZED EXAM DATE
AUTHORIZED START TIME
STANDARD IN-CLASS EXAM LENGTH
(Check One) :
50 MINUTES
75 MINUTES
120 MINUTES
OTHER:
Students are advised to take the exam on the same date & time as the class unless other arrangements have been made with the instructor.
EXAM DELIVERED BY:
Instructor / TA / Department
Student
Campus Mail:
Disability Resource Center
Goddard Health Center, Ste. 166
Fax # 325-4491; pages (including cover sheet)
E-Mail: drc@ou.edu
RETURN EXAM BY:
Instructor or TA Pick Up – Name(s) _____________
Student Return (In sealed envelope)
E-Mail:
***CHOOSE ONLY ONE METHOD OF RETURN***
***IF NO RETURN METHOD IS SELECTED
EXAM WILL BE SCANNED AND RETURNED
BY EMAIL TO THE OU EMAIL ADDRESS***
INSTRUCTOR'S SPECIAL INSTRUCTIONS:
(Mark an “X” in the box to indicate permission and add any additional information in “Other” as needed.)
Use of Calculator
Use of Notes / Use of Books / Scratch Paper
Scantron: 4521* 882-E* 4887* *Available at DRC (please attach any unlisted scantron)
Other (Specify):
-----------------------------------------------DRC Use Only-Do not write below this line------------------------------------------------------

I acknowledge and understand the following:
 Unauthorized materials are not allowed in the testing room (This includes, but is not limited to, cell phones, tablets, laptops, other electronic devices, books, notes, note cards, and crib sheets.)
 Any incidents of academic misconduct discovered by the DRC staff will be reported under the guidelines of the Academic Misconduct Code
 Anyone who engages in premeditated acts of cheating may be subject to a one semester suspension
 Cameras are used to monitor activity in the testing areas
Student Signature___________________________________________________________________________________
