MAKE-UP EXAMINATION FORM

Name of Faculty Member:_______________________     # Copies:________

Telephone Numbers: (Work)_____________________      (Home)__________________

Course Name and Number:______________________      Test I.D._________________

Please List Student's Names: 1._______________________  2.________________________

                                                  3._______________________  4.________________________

                                                  5._______________________  6.________________________

 Last Date Exam May Be Taken:_________________________________________

SPECIAL INSTRUCTIONS:

_____Open Book                                                  Time Limit:____________________

          _____Text
          _____Notes                                              
          _____Tables
          _____Dictionary                                        
          _____Other (Please Specify)
                                                                              
_____Closed Book
                                                                             
                                                                                        
_____Calculator May Be Used

                                                                               _____Student May Write Answers on Exam
_____No Calculators

_____Scratch Paper Needed                                Other Instructions:_____________________

_____Lined Paper Needed                                    _____________________________________

_____Scantron Form Required
          (Specify Type) ________

NOTE: TESTING CENTER SUPPLIES SCRATCH, LINED AND GRAPH PAPER.

TESTS WILL NOT BE GIVEN TO AN ENTIRE CLASS.  PLEASE CONTACT THE LRS DIRECTOR IN AN EMERGENCY SITUATION.

Please remind students that they must show a photo I.D. and a test pass (if required) when they ask for an exam in the Testing Center.

COMPLETED EXAMS may be picked up by the faculty member in the Testing Center.

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