Exam Proctoring Request for Faculty

Complete this form if you would like to have the Testing Center proctor an exam for one or more of your students. Please complete a separate form for each individual exam; however, multiple students who are taking the same exam should be included on the same request. The Testing Center will do our best to accommodate your requests related to timeframe, exam resources, and student accommodations. If we are unable to meet your requests we will reach out as soon as possible to discuss potential alternatives. If you run into any issues or have questions, please reach out to us at testing@jscc.edu.

Today's Date

Instructor's Name

Instructor's Email Address

Instructor's Phone Number (will only be used if there is an issue related to the exam)

Course Title, Section Number, and CRN

First Day of Testing Window

Last Day of Testing Window

Type of Test

Paper and Pencil

Computerized

Is this a make-up exam?

Yes

No

Approximately how many students will be testing?

Student Name(s) (If you are requesting that your entire course be proctored please email a PDF copy of your class roster to testing@jscc.edu)

What exam will the student(s) be taking? (ex. Chapter 3 Quiz, Midterm, etc.)

Allowable Exam Resources (select all that apply)

Additional Information Regarding Allowable Exam Resources (from above)

Test Administration Instructions for Proctors (Please be as specific as possible)

Password (if Required)

Are special accommodations needed? (If yes, ensure that accommodations are approved by the Disability Resource Center prior to testing.)

Yes

No

If student(s) has been granted extra time, please provide the total amount of time allowed for student(s).

Return Process

Provide additional details for your answer to the above question (if needed)

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