TEST ACCOMMODATION REQUEST FORM

** IMPORTANT NOTICE: February 5, 2021 **

** We will be updating our request forms in the coming weeks to reflect the change to online delivery. In the meantime, please submit requests using the form as it is below:

 
1. Use your Speaking Test date in the ‘Test Date’ field.
2. For ‘Test Location’, choose any option from the drop down menu.
3. Use the description boxes to indicate any further details (ex. your confirmed CELBAN CBT date and whether the accommodation is required for both parts of the test).

We apologize for the inconvenience and thank you for your understanding. **

 

If you have a documented disability or special need, you may be able to receive test accommodations. Requests for test accommodations must be made via this online form only. Requests by telephone, email, or fax will not be accepted. The CELBAN Centre grants test accommodations depending on the nature of your disability or need, the supporting documentation provided, and the requirements of the test. The appropriate form of documentation must accompany any special accommodation request form. Your test date and time may change, depending on the required accommodations. Before you complete this form, please review our Policies & Procedures.

  1. If you would like to request test accommodations during your test, please complete and submit the form below.
  2. Please attach all necessary supporting documentation which indicates the necessity and rationale for the accommodation.
  1. Please provide a detailed explanation on how the accommodation is the appropriate solution for the specific need of the test taker.
  2. After submitting the form, you will receive an email confirming your request.
  3. We will contact you again, after we have assessed your submission. Please allow up to 20 business days. To avoid delays, please submit the form only once and ensure all your information is correct.
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TEST LOCATION

  
TEST DATE
dd/mm/yyyy
TEST TAKER INFORMATION

  
  
  
dd/mm/yyyy
 
  
  
TEST TAKER ADDRESS AND PHONE NUMBER





 
 
PLEASE DESCRIBE THE REASON FOR YOUR REQUEST

Statement of the nature of the disability and its severity:

PLEASE DESCRIBE THE TYPE OF ACCOMMODATION REQUIRED

A clear and concise description of the test accommodation(s) requested:
SUPPORTING DOCUMENTATION

Please upload at least one supporting document from a healthcare or counselling professional which indicates a diagnosis and describes your current limitation.
 
MS Word document, PDF, and graphic files are acceptable.