In order to accommodate students and faculty for make-up exams and accessibility exams, we have created an online form that will route directly to our office. Please complete this form 48 hours prior to the test date. Exam Type Make-Up Exam Accessibility Exam Student Information Student First Name: Student Last Name: Instructor Information Instructor's Name: Instructor's Contact Phone Number: Instructor's Email: Class Number/Course: Exam Information Scheduling: Student will be calling to schedule exam Exam has been scheduled *If the student will be calling to schedule the exam, fill out total time given for exam and completed by date and time fields Date of Exam: Other Testing Dates: Exam Start Time: Exam End Time: Total time given for exam (If accessibility, please include extra time if necessary): Exam must be completed by this date: Exam must be completed by this time: Items Allowed During Exam Check all items students are allowed to use. If items are not listed please enter in field box below. Graphing Calculator Nursing/Simple Calculator Book(s) Pen/Pencil Blank Paper Notes Laptop/Computer Blue Book (not provided) Other Other: Special Accommodations (only if an accessibility student) What are the special accommodations the student needs? Scribe/Reader Additional Time Private Room List special instructions you would like to give the proctor: Other Exam Information Past Due Exams: Shred unused, past due exams Return unused, past due exams via campus mail After Exams: Exams will be picked-up by Instructor Exam will be sent through campus mail to room # Please specify building and room to return exams:
