Accommodation Request for NEX Nursing Entrance Exam

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This form is for students who have a disability and are requesting to apply their testing accommodations from the CDS Office for the NEX (Previously called the PAX) Nursing Entrance Exam.

REQUIREMENTS BEFORE COMPLETING:
1. You must have already completed an intake with the CDS Office and are eligible for testing accommodations.
2. You must have already purchased the test!

Please complete this form at least two weeks before your exam date.

First Name *

Last Name *

Your EvCC Student ID Number

Your Phone Number *

Your current email address *

Your Date of Birth

YYYY

Accommodation Requested

Extended Time

Other:

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