Testing Information Form

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DISABILITY SUPPORT PROGRAMS & SERVICES

LEARNING DISABILITIES

CUNN 120  EXT 5330

                                                                                                Locker # ______

TESTING INFORMATION

 

To help us proctor the exam, please complete all information and return this form attached to the exam to CUNN 120

Student's Name: ___________________________________________

 

Instructor's Name:  _________________________________________

 

Days/Times Class Meets:  ____________________________________

 

Test Date: ________________________________________________

Other students in the class room are expected to complete this exam in _______________ minutes.

 

(DSPS Staff use only)  Time started _____ Time Completed _____

 

Without the following information from you, DSPS/LD staff will not allow the student to use any testing materials other than pen, pencil and eraser.

 

Y / N     Open book                                                   Y / N     Take home

 

Y / N     Can use notes                                               Y / N     Use 3 X 5 card

 

Y / N     Can use calculator                                         Y / N     Dictionary

 

Other testing instructions ______________________________________

_________________________________________________________

 

__ Return exam to instructor by campus mail

 

__ Hold for instructor pick-up

 

__ Please use these instructions for the entire semester

 

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Students Name

 

______________________________________________

 

 

The above named student is registered in one of your classes for the ___ semester and may require some assistance with testing due to his/her disability.

 

Please provide the information requested on the reverse side of this notice, so that we might accommodate this student while at the same time insure the integrity of your testing procedures.

 

If possible please deliver the test along with this form with instructions filled out prior to the date of the examination.

 

If more convenient, you may choose to e-mail your tests to either

ssoria@deltacollege.edu    or    cgarcia@deltacollege.edu

 

Some tests may require us to enlarge, tape or otherwise put in an accessible format, so it is important that we get the tests

in a timely manner so that we might prepare them in advance.

 

Pop quizzes may present some difficulties, please contact us directly to discuss how we might be able to assist you

 

Tests that are received are locked in a cabinet that is only accessible to permanent employees working in our division.

 

Tests not taken on  the appointed date and time will be mailed back to instructors at the conclusion of the test day

 

  

Please feel free to call or drop by at any time regarding testing or any other questions or concerns you might have.  We are located in Cunningham 120 and can be reached at ext 5330.

ix                                      Revised 02/08