Faculty – Request a Special Test By submitting the Request for Special Testing Form you agree to the Faculty Agreement for Testing. Faculty - Request a Special Test Use this form to submit a request for special testing. Instructor Name(Required) First Last Office Phone Number(Required)Additional Phone Number(Required)cell phone, home phone, pagerEmail Address(Required) Backup INSTRUCTOR at UAMS(Required)In the event you are unavailable, your backup instructor must have INSTRUCTOR ACCESS to the course to resolve any issues with the test. First Last Backup INSTRUCTOR's Office Phone Number(Required)Additional Phone Number for Backup INSTRUCTOR(Required)cell phone, home phone, or pagerCollege(Required)Select oneCollege of Health ProfessionsCollege of MedicineCollege of NursingCollege of PharmacyCollege of Public HealthProgram/Course Name(Required) Number of students taking the test in the Special Testing Center(Required) Names of students taking the test in the Special Testing Center - please indicate the special accommodation for EACH student(Required)Test InformationTest Name/Number(Required) Exam DATE(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Exam TIME Hours : Minutes AM/PM AM PM AM/PM Exam LENGTH Please indicate the length of time allowed for this test(Required)Please note: The Testing Center closes at 6PM. All students must be finished and have submitted their tests by that time.Regular testing timeTime and a halfDouble timeTest Delivery Method(Required)Select oneBlackboardBlackboard Lockdown BrowserATIFISDAPExamplifyOtherIf "Other", please specify web address for web-based tests. Test Password(Required) Download Passwordif applicable Review Passwordif applicable Please specify any materials allowed during the test.(Required)Check all that apply. You can upload handouts below, or email them to email@example.com. Please email files larger than 15MB. None Scratch paper Calculator Handouts (upload below) Manuals Notes Textbook Upload handouts here.Please email any files larger than 15MB to firstname.lastname@example.orgMax. file size: 15 MB.Maximum file size - 15 mega bytes. EmailThis field is for validation purposes and should be left unchanged.