Assessment Services Instructor Make-up Test Administration Form

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Assessment Services

Instructor Make-up Test Administration Form

Note: Please ensure that the Instructor’s Name, Course Title/Number, and Test Number is on each test left with Assessment Services.

INSTRUCTOR: ________________________________________________________

PHONE NUMBER OR EXT :_________________________________________

E-M AIL :______________________________________________________________

COURSE / TEST NUMBER:_____________________________________________

REQUIRED COMPLETION DATE: _______________________________________

ARE STUDENT NAMES POSTED ON THE TESTS?

_____ _____

(I F NO IS SELECTED , STUDENT MUST PRESENT A TEST PASS ) YES NO

ANSWER FORMAT:

SCANTRON- _______

ALLOWED TO WRITE ON TEST- _______

SPECIAL ANSWER FORM- _______

MATERIALS ALLOWED :

*** Beginning in the 2014 Academic year, mechanical pencils are no longer permitted.***

Pencils will be provided.

Please inform your students of the new guideline.

CALCULATOR( WHAT TYPE ?)

_______________

BOOKS- _____________________

NOTES_________________ _______

OTHER- ____________________________

SCRATCH PAPER(

CIRCLE ONE

) YES / NO

(S CRATCH PAPER WILL BE ALLOWED IF NO SELECTION IS MADE

…)

ADDITIONAL INSTRUCTIONS: _____________________________________________

__________________________________________________________________

___________________________________________ ___________

INSTRUCTOR SIGNATURE DATE

Instructors must deliver and/or pick up exams in person or use the Instructor Make-up

Testing Proxy Form. ***Daytona State College identification must be presented.

AS doc. revised 08/22/2014

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