Testing Accommodations Application

Personal Information

First Name

John

Middle Name

Frederick

Last Name

Example

Suffix

Jr.

NCBE Number

N10000000

Last Four of Social Security Number

Date of Birth

January 10, 1961

Handedness (Right Handed, Left Handed)

Contact Information

Mailing Address

Organization

Sonic Inc.

Address 1

3855 Lake Clearwater Place

Address 2

Apt. 222

City

Sarasota

State

Florida

County

Marion

Zip Code

90210

Country

United States of America

Email Address

sample@email.com

Primary Phone

(812) 111-5100

Cell Phone

(812) 111-5101

Office Phone

(812) 111-5102

Other Phone

(812) 121-5203

Accommodations

I have submitted a bar exam or LLP admissions application

I understand that all information I provide with my accommodations submission, including evidence of prior accommodations and medical treatment provider documents, will be subject to verification

I understand that any falsified documentation, fraudulently created or procured documentation, or documentation obtained through means prohibited by law will be grounds for denial of accommodations and for a Character and Fitness investigation

Medical Aids or Devices

Are you submitting a notice of a Medical Aid or Device to the Office of Attorney Admissions(OAA)?

I confirm I have read the Medical Aid or Device Instructions available at OAA's website

I understand that I am not permitted to plug any device into my computer. If a medical device includes an accompanying external remote-control device, such as a cell phone, the remote-control device may not be taken into the testing room. If there is a need to take the external remote-control device into the testing room, including a cell phone, I must apply and be approved for an accommodation

I understand that a Medical Aid or Device cannot alter the standard exam administration. If the aid or device requires an alteration, I must apply and be approved for an accommodation

I confirm I have reviewed the Pre-Approved medical aid and device list available at OAA's website

I understand that the Medical Aid or Device is subject to security screening at the exam site

Is OAA authorized to leave a voicemail on the phone number I provided in my admissions application?

Provide how we may contact you about your Medical Aid or Device

Alternate Phone Number

Alternate Email

I require the following Medical Aid or Device (select all that apply):

Inhalers

Auto-Injector, such as EpiPen

Braces – Neck, Back, Wrist, Leg, or Ankle

Casts – including slings for broken/sprained arms or other injury-related items that cannot be removed

Eye Patches

Glucose Tablets (does not include hard candy) – must be unwrapped and not in a bottle/container

Hearing aids/Cochlear implant

Medical Alert Bracelet

Continuous Glucose Monitor

Insulin Pump

Spinal Cord Stimulator

TENS Unit

Medical Foot Stool – Must be for the purpose of supporting an injured leg or foot. The stool must be non-skid, have a metal base, and can be no larger than 14x14x12

Oxygen Tank – Must be self-contained and silent

Canes

Crutches

Motorized Scooters/Chairs

Walkers

Wheelchair

Other Medical Device – Must be attached to the applicant’s body and be silent

Prior Accommodations from CO

I have received testing accommodations from the Colorado Office of Attorney Admissions (OAA) on a prior bar or LLP exam

I confirm that there has been no change to my condition, AND functional impairment, AND I am requesting exactly the same accommodations previously granted by the OAA

I confirm the information provided in support of my Re-Application Request is true and complete

I understand that if the OAA determines that I, or a third party on my behalf, submitted as part of this request any information or documentation that is false, inaccurate, or intentionally misleading, the OAA reserves the right to withhold or nullify my bar examination scores and treat such conduct as a character and fitness issue

I understand that all necessary documentation and information must be provided to the OAA by the deadline and that my Re-Application Request may not be considered or may be denied if filed after the applicable deadline

Is someone assisting you with completing this application?

	Please explain

Exam Type

Date of Prior Exam

Date of Exam to which you seek a Re-Application of Test Accommodations

Accommodations received

Can OAA leave a voicemail at the Primary Phone Number listed in your exam application?

Can OAA leave a voicemail at the Alternate Phone Number listed in your exam application?

Testing Accommodations

Are you submitting testing accommodation documentation to the Office of Attorney Admissions (OAA)?

I confirm I have read the Testing Accommodations Instructions available on OAA’s website.

I understand that the purpose of test accommodations is to provide applicants with access to the test. The purpose is not to ensure improved performance, a passing score, test completion, or other specific outcome(s)

I understand that the filing deadline for accommodation documentation submission is:

BAR EXAM

February Bar Examination – December 1st
July Bar Examination – May 31st

LLP EXAM

April LLP Examination – February 1st
November LLP Examination – September 1st

I confirm I have familiarized myself with each Document Type and their requirements

I understand that my accommodation submission will be complete when uploaded (i.e. I will have no additional documentation to include. I will not be permitted to submit additional accommodation documentation, at a later date, as part of my original submission)

I understand that all documentation must be in PDF or WordDoc format. Pictures of documents, such as jpegs, are not permitted. Also, I understand that documents cannot be password protected

I understand that I am required to provide a personal statement that (1) specifies the accommodations I require to access the exam, and (2) explains how my disability affects my functioning in major life activities and might impact equal access to the exam under standard conditions

I understand that my personal statement must be specific and that a general request will be deemed incomplete. (E.g., “I require 25% extra test time on all test sessions” is a specific request, while “I need extra time” will be deemed incomplete.)

I understand that OAA may ask questions about any documents I submit, including my personal statement

I understand that OAA may require me to provide additional statements and/or documentation after its review of my accommodation submission

I understand that OAA will provide me with notice and a deadline by which I may remedy any deficiencies in my submission

I understand that I have the right to appeal OAA’s determination by the deadline specified in the Notice of Determination

I understand that OAA’s determination of my appeal is final

Streamlined or Standard Process

Will you be submitting documents under the Streamlined Process OR the Standard Process? Information about these processes is available on OAA’s website

Please ensure that your documents adhere to the document category requirements listed on OAA’s website

I am submitting the following documentation:

Category A documents (documentation from a professional who knows the applicant well)

Please upload the Category A document to the Required Documents section of the User Home Page.

Category B documents (documentation of certain types of prior accommodations)

Please upload the Category B document to the Required Documents section of the User Home Page.

Category C documents (documentation of prior accommodations from institutions of higher education)

Please upload the Category C document to the Required Documents section of the User Home Page.

Category D documents (medical evaluation(s))

Please upload the Category D document to the Required Documents section of the User Home Page.

Other (Please explain)

	Please provide a statement as to why you are submitting this additional/other documentation

Please upload the document to the Required Documents section of the User Home Page.

Confirmation

I confirm my accommodation documentation submission is complete, and I have no other documents to provide to OAA for its review.