TUTORIAL SERVICES EXAMINATION COVER SHEET
ROOM 10-444 512-2792
Instructions: This form must be completed and submitted along with all testing materials to the Tutorial Center.
Student Name_____________________________________________________________________
Course Number__________________________________________________________________
Today’s Date____________________________________________________________________
Instructor’s Name______________________________________________________________
Office Room Number________________________ Phone Number_______________
Description/Title of Test_________________________________________________
Time Limit____________________________________________________________
Specific Instructions: (Check all that apply)
| Closed Book___ | Use of Notes___ |
| Open Book___ | Use of Dictionary___ |
| Use of Calculator___ | Other (Please Specify___ |
Answer Format:
| On the test itself___ | Scan Form___ |
| Notebook Paper___ | Answer Sheet Provided___ |
| Blue Book ___ | Other (Please Specify)___ |
Additional/Special Instructions: ______________________________________
Date test must be taken by: __________________________________________
Tests must be scheduled 24 hours in advance and at a time to assure completion of the test within operational hours of the Tutorial Center. Test proctors will not be scheduled until students have attended the last class before the test date.
| Hours: Fall, winter, and Spring Quarters |
Summer Quarter |
| Mon thru Thurs 8:00 am to 8:00 pm | Mon thru Thurs 8:00 am to 5:30 pm |
| Friday 8:00 am to 5:00 pm | Friday 8:00 am to 4:30 pm |
| Saturday 10:00 am to 2:00 pm |
INTERIM HOURS VARY |
Date received by Tutorial Services: ___________________________________
Completed testing materials will be:______________________________________
| Delivered to___ | Name______________________________ |
| Will pick up___ | Office______________________________ |
| Mailed to___ | Address____________________________ |
| City_______________ | State___________________Zip_________ |
Delivered by:________________________ Room_______ Date_____________
