Accessibility Resource Center
Accessibility Resource Center
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Exam Proctoring Authorization Form

 

This form must be completed, signed, and delivered to the ARC before exam will be administered.   It is the responsibility of the student to schedule exams with the ARC at least one week prior to the exam date.  Testing outside the classroom or academic department is warranted only if circumstances prevent the  instructor from making localized arrangements or if the student needs assistive technology at the ARC.   Failure to schedule an exam one week in advance may result in the ARC staff being unable to accommodate the requested time and date for the exam.  If the student is caught cheating, the instructor will be notified, and testing accommodations may be revoked.  The ARC staff will email the instructor if an exam is not retrieved by the end of the semester in which it was taken.  An exam left in the ARC after such notification will be filed in the respective student’s file.

 

PLEASE PRINT CLEARLY:

Student’s Name: ______________________________   Course Name and Number: ______________________       

Exam Date: _________________              Exam Time: __________    Exam Location: __________________

Student Signature: ________________________________  Date:  __________________________________


  Please initial all pertinent rulesand mark            

  throughthose rules that do not apply (to be

  completed by the instructor).

 

_____   Book(s) may be used:

Title:_________________________________

_____   Notes may be used

_____   Dictionary may be used

_____   Calculator may be used

_____   Scratch paper may be used

_____   Student may keep test questions

_____   Student may keep scratch paper

_____   Other – Please Explain:

______________________________________

 

Time allotted for the class to take the exam: _____

Instructor’s Name: __________________________________

Instructor’s Signature: _______________________________

Date: _____________________________________________

Office Address: ____________________  Phone:___________

_____  I wish to pick up the completed exam at the ARC.

_____ Scan and email the completed exam to me.

_____ Send completed exam via campus mail in a sealed envelope.

_____ Send completed exam via student tester in a sealed envelope.

_____ Exam to be completed via Blackboard.  Password = _______ 


(Office Use Only)

Date Exam Received: _____________   Staff Initials: _____   Assistive Technology: __________________________ 

Date Exam Administered: __________ Time Started: __________ Ended: __________   Staff Initials: ____________

Comments: ____________________________________________________________

Pick up: _____________________________________________     _______________                                                  

                                     Instructor/Staff Signature                                             Date                                                                                                                                  

 

 

 

I decline the recommended accommodations for this exam and waive the right to use these accommodations.
Student’s Signature: _________________________________________   Date:  _________       
           
                                                                                                                                                                         06/14

 

Directions for Accessing Exam Accommodations

 

The Accessibility Resource Center (ARC) staff offer exam accommodations for students with disabilities such as extended time, alternative format, and assistive technology, depending on the student’s disability.  These accommodations are implemented to give students with disabilities equal access to testing and accommodates for certain limitations related to the student’s disability.

 

Testing outside the classroom or academic department is warranted only if circumstances prevent the instructor from making localized arrangements or if the student needs assistive technology at the ARC.  Therefore, when testing accommodations or alternative testing is needed, students are responsible for discussing this issue with the instructor to make the appropriate arrangements to have the exam administered.  It is the responsibility of the student to schedule exams with the ARC at least one week prior to the exam date.  Failure to schedule an exam one week in advance may result in the ARC staff being unable to accommodate the requested time and date for the exam.  The ARC staff will make every effort to accommodate students in a timely and reasonable manner.

 

Standard testing procedures for the ARC:

  1. Students must complete an exam proctoring authorization form in order to notify the ARC staff of their needs for alternative testing and accommodations. 
  2. This form must be completed, signed, and delivered to the ARC by the student before exams will be administered. The student’s name, exam date, time of the exam, and the course name and number should be specified on the form. Instructors should indicate on the form any materials that the student can use during the exam, any directions that the student should be made aware of in order to take the exam, and the amount of time allotted for the rest of the class to take the exam.
  3. Students should submit an exam authorization form to the ARC at least one week prior to the examination date and request that instructors make arrangements to have the exam sent to the ARC. 
  4. Instructors may arrange to have the exam delivered to the ARC, email the exam as an attachment, fax the exam, or have the student deliver the exam in a sealed and signed envelope prior to exam start time. 
  5. The ARC staff will proctor the exam on the date and time indicated on the authorization form while providing the student’s accommodations. With the exception of evening classes, the student should take the exam the SAME TIME the class regularly meets unless the instructor provides permission for an alternate time. The ARC staff are authorized to proctor the exam only during the time specified by the instructor on the exam proctoring authorization form. 
  6. The instructor should specify the preferred retrieval method for the completed exam on the exam proctoring authorization form.  The ARC staff will email the instructor if an exam is not retrieved by the end of the semester in which it was taken.  An exam left in the ARC after such notification will be filed in the respective student’s file.  

 

 

 

Students who arrive at the ARC late for an exam may have this time deducted from their scheduled testing time.  If a student does not come in to take a scheduled exam at the ARC, the examination will be returned to the instructor.  Therefore, students must have the instructor approve any change in time or date of administration of an exam before the ARC staff will make an appointment to reschedule proctoring the exam again.

 

Thank you for your assistance in this testing process!

06/14

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