Testing Cover Sheet

Please schedule & submit test at minimum 48 hours (2 business days) prior to the requested test date & time.
Faculty and student should work together to schedule a testing time that fits the student's schedule and does not conflict with another class time.
CAPS Testing Center Hours
Monday-Wednesday (8AM-5PM), Thursday (8AM-6PM), Friday (8AM-4PM)
Student Name*
Student Email*
Faculty Name*
Faculty Email*
Faculty Contact Number*
Test Name*
Course Name*
Where do you want the exam/quiz returned to*
Does student have a LOA*
- Yes
- No
Enter Date of Test (MM/DD/YYYY)*
Enter Time of Test (Hour/Minute/AM/PM)*
If student needs to reschedule, student must complete test by this date (MM/DD/YYYY)*
Original Time Limit (REQUIRED) (ex. 75 mins)*
+50% or /100% time
= Total Time Limit
Please complete the following section regarding the parameters of the assessment. Remember to include approved assessment accommodations in this section. Approved assessment accommodations can be found in the student's Letter of Accommodations (LOA).
Student requests scribe and/or reader (can only use if on LOA)? Test date/time may be adjusted for scribe/reader availability.*
- Yes
- No
Textbook Allowed*
- Yes
- No
Notes Permitted*
- Yes
- No
Calculator*
- Yes
- No
Computer (including access to Internet)*
- Yes
- No
Word processor with spellcheck/grammar check*
- Yes
- No
Dictionary-Thesaurus*
- Yes
- No
Additional Instructions/Comments- If not submitting test explain in the Comments section and provide the date when the test will be provided to CAPS.
DISCLAIMER: Proctors will routinely check on testers but will not physically sit in the testing room unless prearranged by faculty or administrator. CAPS personnel may come into the testing room to monitor activities at any time. If we find any evidence of a student not following the rules or procedures, the exam will be stopped, the faculty member will be notified immediately, materials will be confiscated, and the matter will be turned over to the faculty member for further action.
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12-18
Average class size

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