Student Disability Services

Exam Proctoring Checklist

If you are receiving this Exam Proctoring Checklist via email, click REPLY, then complete the information below, attach the exam, and click SEND to transmit your information toDisabilityServices@ccsu.edu. OR Click on REPLY, complete, print and select an alternative method of exam delivery.

 

Last:          

First:

Course/Instructor:

Date/time of exam:

What is the time allotted for students taking the exam in class? 

Please check all items that are permitted in the test area:

 

open book

 

notes

 

calculator

 

formula sheet

 

scrap paper

 

Blue Book (s)

 

Scantron Sheet(s)

 

other (PLEASE EXPLAIN)

 

 

 

If a question may arise during the exam, please list the name and phone number of instructor or designee who will be available during the time the student taking the exam.

Instructor/Designee:          

Phone:

 

For on-line exams, please provide details required to facilitate the exam session:

Exam delivery:

 

E-mail the exam with this completed form to DisabilityServices@ccsu.edu

 

Fax the exam to 860-832-1865

 

Drop off the exam to SDS (Willard 101-03) located in the Learning Center (Willard 101)

Exam return:

 

Faculty or department secretary will pick up exam from SDS (Willard 101-03) located in the Learning Center (Willard 101)

 

Send by campus mail to this department:

 

Scan completed exam to faculty e-mail (Exam must be on single-sided 8.5X11 paper; cannot scan exams with Blue Books)

 

Signature/Date at time of exam pick up from SDS (Willard 101-03) located in the Learning Center (Willard 101)

 

Signature: ____________________________________________________Date:________________

Click Here to Open/Print this Exam Proctoring Checklist (.PDF)

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