Banacos Exam Reservation Form

Reservations to take your exam at the Banacos Academic Center must be made at least 2 business days prior to the exam date and 7 business days for assistive technology, readers, scribes, or different room arrangements. Students are required to complete all information before submission.

Today's Date:	*
First Name	*
Last Name	*
Student Cell #
WSU Email	*
Are you registered to receive accommodations?	* If no, please see the Access Advisor	Yes No
Have you written or talked to your professor about taking the exam here?	*	Yes No
Course Number (i.e. MATH 0111):	*
Professor:	*
When is your class?
Days	*
Time	*
Exam Date:	*
Time you will start your exam (i.e.; 8:15 a.m.):	* **If this is a time other than your class time, we must have your professor's permission
Which accommodations will you need for this exam?	They much be approved by your Banacos Academic Center Advisor
		50% extended time
		100% extended time
		Computer
		Other
		Formatting (larger font, spacing, etc.)
		Kurzweil
		Dragon
		Room Alone
Do you need a reader?	*	Yes No
**If you need a reader:		Reader Requested:
		Please find me a reader
Do you need a scribe?	*	Yes No
**If you need a scribe:		Scribe Requested:
		Please find me a scribe
How will the exam get to the center?	* **if the exam is on PLATO, please check off that you will be bringing the exam	Exam Room staff should contact the professor Professor asked me to bring the exam here
To be completed by examroom staff: