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Forms for Student Use

  • Each semester eligible students must request Accommodations Letters to submit to instructors and discuss implementation of accommodations
  • New students must contact the ADA Accommodations Office.

Test Proctoring Services are provided only for JSCC students

who have registered with the ADA Accommodations Office.

Test proctoring is provided as a service to assist instructors in their efforts to provide testing accommodations for students with disabilities.  While it is preferable for students to take tests within close proximity to instructors, the ADA Accommodations Office is available to assist when this is not possible. Tests are proctored ONLY for students registered with the ADA Accommodations Office.

Test Proctoring Form is completed only if the instructor is unable to proctor the exam.

Test Proctoring Form

Test Proctoring Locations:

  • Jefferson Campus
    • ADA Accommodations Office, Fitzgerald Student Center, Room 300; 205.856.7731 or email
    • Jefferson Campus Learning Resource Center [Allen Library]; 205.856.7788 or email
  • Shelby Campus
    • Shelby Campus Learning Resource Center, General Studies Building Room 122; 205.983.5930 or email
  • St. Clair - Pell City Campus
    • Enrollment Services. Pell City Center Room 121; 205.812.2700
    • St. Clair Campus Learning Resource Center, Pell City Center Room 117; 205.812.2713 or email
  • Chilton - Clanton Campus
    • Enrollment Services, Room 113; 205.280.8201
    • Chilton Campus Learning Resource Center, Room 114; 205.280.8213 or email

Student Responsibilities

  • No later than two business days prior to the date of the test student must return the completed proctoring form to the ADA Accommodations Office and schedule the test time.  NO tests will be administered without a completed proctoring form.  (Testing space is assigned on a first come first serve basis)
  • Fill out the student information section on the proctoring form and sign.  Present the form to faculty member before the exam and discuss specific test proctoring needs and plans.
  • Student must present the instructor with an Accommodation Letter for the current semester.
  • Must abide by the Jefferson State Academic Honesty Code.
  • Only approved instruments/materials allowed in the testing area.  No coats, backpacks, purses, cell phones, or other electronic devices are allowed in the testing room.
  • Must be on time for the test.  (Exam will not be administered if arrival time is 15 minutes after the instructor’s stated start time and test time begins at the instructor’s designated start time.)

Faculty Responsibilities

  • Discuss with the student specific test proctoring/accommodation needs and plans.
  • Complete Test Proctoring Form, including specific accommodation needs and test routing procedures.
  • Hand deliver/email ( the test to the ADA Accommodations Office or proctoring site no later than 12p.m. the business day before the test.
  • Failure to abide by the Policies and Procedures set for by the ADA Accommodations Office indicates that you will be responsible for providing testing accommodation for the student.
  • This form is to request release of information to another college or university.
  • You must complete the form in its entirety, sign the form and return to the ADA Accommodations Office via the following:
    • Email at
    • Upload your completed form here
    • Deliver to the ADA Accommodations Office:
      • Jefferson Campus:  Fitzgerald Student Center, Room 300
      • Shelby-Hoover Campus:  General Studies Building, Room 120
      • St. Clair - Pell City Campus:  Enrollment Services, Room PCC #121
      • Chilton-Clanton Campus: Enrollment Services, Room CC #113