Make-Up Examination Proctoring

Section 1

1. Instructor:

2. Course Name & Number:

3. Test Expiration Date:

4. Student Name:

5. Exam Time Limit:

6. Type of Test Administration:

Paper-based

Online Using Blackboard

Section 2

1. Resources Student May Use When Testing (Check all that apply):

No Materials Allowed

Formula Sheets

Calculator

Dictionary

Class Notes

Syllabus

Books (Please specify below)

Other Special Instructions (specify below)

Blank Notebook Paper

Books

Other Instructions

Section 3

1. Completed Exams Should be Returned By (select one):

University Mail Distribution

Hold for Instructor Pick Up

Scanned and Forwarded Electronically

Submit