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Indiana University Kokomo
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Testing Form

In order to accommodate students and faculty for Make-up Exams and Accessibility Exams,
we have created an online form that will route directly to our office once it has been completed. Please complete this 48 hours prior to the test date.

Student Name:

Make-Up Exam
Accessibility Exam

Please mark all that applies to your student needs

Instructor's Name:
Testing Date:
Time and date test must be completed by:
Exam Start Time:

Exam End Time:

Total time given for test (please include extra time if necessary)
Instructor's Contact Number:
Instructor's Email:
Class Number:

Check all items students are allowed to use. If items are not listed please use the other box to list them.

Calculator
Book(s)
Pen/Pencil
Scrap Paper (Testing Center does not provide this)
Notes
Laptop/Computer
Nursing Calculator
Other:
What are the special accommodations the student needs? Scribe
Additional Time
Quiet Room

If yes, let the student know they will need to notify the Accessibility Center set up these services. List special instructions you would like to give the proctor.

Comment:
Scheduling: Student will be calling to schedule exam
Exam has been scheduled

Past Due Exams:

Shred unused, past due exams
Return unused, past due exams via campus mail

After Exams:

Exams will be picked-up by Instructor.
Exam will be sent through campus mail to room

Other:

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