Please indicate the actual exam/test time in the classroom:
Regular Exam/Test Day:
Regular Exam/Test Date:
Regular Exam/Test Start Time:
hr: mins/am or pm
Student is allowed the following during the exam/test:
No. 2 Pencil
If notes are allowed, please describe (full notes, 1 page front and back, etc.):
To facilitate the transfer of the exam/test to our proctor, please choose from the following options:
I (the instructor) will e-mail the exam/test to the proctor at firstname.lastname@example.org
I (the instructor) will deliver the exam/test to Disability Services.
I (the instructor) will send the exam/test through campus mail in a sealed interdepartmental envelope.
How would you like the exam/test returned to you?
I (the instructor) will pick up the exam/test from the Disability Services office.
Put in campus mail in a sealed envelope.
Scanned and e-mailed back to me (the instructor) in a PDF file.
Questions or Comments: