Test Proctoring Request Form

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Test Proctoring Request Form

The Skyline College Learning Commons provides proctoring for individual make-up exams. Proctoring requests must be made by the instructor. Proctoring is available Monday-Thursday 9:00am-3:00pm and Friday from 9:00am-1:00pm. Please allow up to 5 business days to process the request. *Students registered with the Disability Resource Center (DRC) should continue to work with the DRC for proctoring and testing accommodations.

Instructor Name ✱

Instructor Email Address ✱

Instructor Phone Number

Division/Discipline

Course Name/Number ✱

Proctoring will be provided by:

Matrix row labels are in this column	Options
Division staff	Value for matrix segment M1, row R1, column C1
Learning Commons staff	Value for matrix segment M1, row R2, column C1

Comments:

Student Name ✱

G Number ✱

Student Email Address ✱

10.

Student Phone Number

11.

Requested test date ✱

12.

Requested test time (Proctoring hours: Monday-Thursday 9:00-3:00 and Friday 9:00-1:00. No service after hours, on Saturday, and during Fall/Spring recess. ✱

13.

Time Allotted For Exam (minutes) ✱

14.

When is the last day to make up exam in case of no show or cancelation?

Not applicable

15.

Items allowed in test

Matrix row labels are in this column	Yes	No
Calculator	Value for matrix segment M1, row R1, column C1	Value for matrix segment M1, row R1, column C2
Textbook	Value for matrix segment M1, row R2, column C1	Value for matrix segment M1, row R2, column C2
Notes	Value for matrix segment M1, row R3, column C1	Value for matrix segment M1, row R3, column C2
Dictionary/Thesaurus	Value for matrix segment M1, row R4, column C1	Value for matrix segment M1, row R4, column C2
Internet Access	Value for matrix segment M1, row R5, column C1	Value for matrix segment M1, row R5, column C2
Other (Please specify in comments)	Value for matrix segment M1, row R6, column C1	Value for matrix segment M1, row R6, column C2

Other comments?

16.

Upload Your Test

Exam Upload

17.

Adhering to testing guidelines, students are not allowed to return their make-up exams. How would you like the finished exam returned/delivered?

Interoffice Mail, Office Number:	An answer is requiredInteroffice Mail, Office Number:
Delivered to Mailbox, Type in Mailbox:	An answer is requiredDelivered to Mailbox, Type in Mailbox:
Delivered to Office, Type in Office Location:	An answer is requiredDelivered to Office, Type in Office Location:
Other, Please Specify (Students cannot deliver their finished make-up exam). Other:	An answer is requiredOther, Please Specify (Students cannot deliver their finished make-up exam). Other:

18.

Additional Requests/Information/Comments