Columbus State Community College

COLUMBUS STATE COMMUNITY COLLEGE COLLEGE TESTING SERVICES - TESTING CENTER COLUMBUS CAMPUS – AQUINAS HALL 002, 614-287-2478

D I S T A N C E L E A R N I N G T E S T A D M I N I S T R A T I O N R E Q U E S T F O R M TESTS MUST BE HAND-DELIVERED or E-MAILED to [email protected] AT LEAST 48 HOURS PRIOR TO ADMINISTRATION. TESTING MATERIALS NOT PICKED UP BY THE END OF THE SEMESTER WILL BE SHREDDED. I N S Name: T Last Name First Name R Phone: U C Office Home/Cell T Department: Bldg/Room O R

C O Semester: Au Sp Su Course Name & Number: (example CSCI 1101) U R Blended Video Web ( Flex Term Course) S E Course Synonym(s): 5-digit number Additional Instructors/Team Teaching:

E X Exam (e.g., Midterm, Final Exam, Unit 1, Quiz 2): A M Available Date: Deadline Date: *Time Limit:

Exam extension info: see next page if checked. I Hour(s) Minutes N Number of Exams Submitted: *Time limit left blank or open will default to 2hrs F O **Exams will be available at ALL CSCC testing centers unless otherwise specified below in Special Instructions.**

STUDENT MAY USE: ANSWER FORMAT (supplies provided by instructor) Book(s) – List specifically in Special Instructions Answer sheet provided Write answers on exam Essay booklet Calculator Basic(non-programming) Graphing Jump drive provided Dictionary/Thesaurus Scantron: 50q 100q 200q Other Electronic Translating Blackboard (Paper copy of test must be provided as backup.)

Notes Crib Sheet(s) NOTE: Testing Center staff will clear attempt if students are locked out and/or give paper copy of test if network is down. Other Password NO MATERIALS ALLOWED Online Assessment (ex. SNAP) SPECIAL INSTRUCTIONS:

R E Mailroom Delivery-Campus Mailbox (available up until the last two weeks of the semester; instructor pick up thereafter) T Instructor Pick Up (or Designee) (Photo ID required) U R NOTE: Delivery method may not change with each exam; first request will be adhered to. N O RECEIVED PROCESSED Regional Centers Out-of-City Delaware Campus F F Drop Off E-mail E x a m s P u l l e d f o r T e s t i n g L o c a t i o n s I C Date: Date: Date: Date: Date: E Initials: Initials: Initials: Initials: Initials:

Testing Center: white Instructor: yellow Rev 12/10/13 DATABASE: INTAKE: U S Initials Initials E

Testing Center: white Instructor: yellow Rev 12/10/13