Student Accessibility Services Exam/Quiz Proctor Sheet
DeWeese Center, Ground Floor Rm. 23 ٠ P: 330-672-3391 ٠ F: 330-672-3763 ٠ E: sas@kent.edu
Professor/Instructor Please Fill Out Exam/Quiz Information
Course &
Section No.
Amount of time class receives
for exam/quiz:
Amount of extended time
+
permitted:
Subject:
CRN:
Student Name:
Course Name:
Faculty Name:
Phone/Email:
min
min
Total time for SAS student:
min
Date & time class takes exam/quiz : Did the student receive professor permission to take this exam/quiz on a different date/time thaŶ the class? Yes: No:
If yes, date(s)/time permitted:
Exam/Quiz Type: Multiple Choice:
Essay:
Math:
Listening:
PC:
Respondus:
Student May Use:
Calculator
Book(s)
Notes
Scantron
Completed Exam(s):
Pick up exam from SAS
SAS delivers exam to Dept.
Scan and e-mail
Other:
Color Preference:
Exam/Quiz Instructions:
SAS Office Use Only
Student Cheating Policy & Exam/Quiz-Taking Expectations
I am aware of and understand the Kent State University administrative policy regarding student cheating and plagiarism (Policy Register 3342-307). I
understand that I am NOT permitted to leave the testing room until I am finished with my exam/quiz. If I believe that I will need to use the restroom during
my exam/quiz, it is my responsibility to let the SAS proctor know prior to the beginning my exam/quiz; and I understand that I will then need to complete
the exam/quiz page by page, and will not be permitted to view or work on any previous pages when I return from being out of the testing room. I also
understand Student Accessibility Services hours are Monday through Friday 8am-5pm and that there may be a change in SAS proctors during this exam/
quiz and that my exam/quiz will be collected 15 minutes prior to SAS closing during the academic year and 30 minutes prior to SAS closing during final
examinations.
Student Signature: _________________________________________________________________ Date: _______________________________________
Exam/Quiz Apt: _________________________ Time: _______________________________
Date Rcvd: __________ Rcvd By: E
D
O __________ Staff Initial: __________
F
Room Alone
Computer
JAWS
Braille
Terp
Scribe
Reader
Proctor
CD/TAPE
DVD/VCR
Start Time: ______________
Staff Initials: ________
End Time: ______________
Proctor Sheet by:
Instructor
CCTV
SAS
Enlarge: _______
Other: _________________________
Staff Initials: ________
Total time: ____________
Delivery information:
Return Information:
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Done by: ____________
Location:___________________________
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Date: _________
Time: __________
Delivered by: ____________
Date: ________
Time: ________
Delivered by: ____________
Date: ________
Time: ________
Pickup (Signature): _______________________________________
Rcvd by (Signature): _____________________________________
(Print): _______________________________________
(Print): _____________________________________