CPI TEST FORM

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COMPLETELY ONLINE CLASS

INTERACTIVE TV CLASS

NON IRSC TESTING SITE

TRADITIONAL OR BLENDED CLASS (Only Individual Make Up Exams)

TEST FORM

Campus Destination

(circle or highlight all that apply):

Main Chastain Mueller

Dixon Hendry Pruitt Non IRSC Testing Site

# of paper tests enclosed :

Instructor :

Testing Dates : from: through:

Allotted time : Test title :

IRSC office extension :

Course Number :

Answer Format :

(circle or highlight all that apply)

Angel Online

Scantron

Test paper(s)

Notebook paper

Gordon Rule paper

Microsoft Word for essay

Provided Answer sheet

Math XL:

Other :

Ref. #:

Allowable Aids:

Off campus phone :

Comments :

(circle or highlight all that apply)

None

Scrap paper (must be turned in)

Student notes

Dictionary/Thesaurus

Textbook (only printed copies)

E-Books (proctors are not able to monitor content on E-Books)

Allow calculator: Yes No

clear memory: Yes No

Other:

Student(s): (Attach list :highlighted student names or class list for online computerized exams)

IRSC 30 (Revised 7/2013)

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