Testing and Assessment Center Request Form for Proctoring Services

This form is used for students who cannot attend a scheduled on-campus exam due to a conflict or absence.

The completed form, along with a PDF file of the exam and instructions, are required to be submitted by the instructor (2) business days in advance of the requested exam date.

Please allow flexibility in requests being processed. Dates and times are subject to change based on availability. A confirmation email will be sent within (2) business days of your request.

The Testing Center hours of operation are:

Monday-Thursday, 8am-5pm.

Exams must be scheduled to finish by 5pm.

Note: Students with disabilities should work with the Disabilities Resource Center (DRC) to schedule all exams via Clockwork. DRC website: http://foothill.edu/drc

Enter Student's CWID*

Enter Student's First Name*

Enter Students Last Name*

Enter Student's Email Address*

Enter the Course Title*

Enter the Course Section*

Please enter your last name*

Please enter your first name*

Please enter your email address*

Please enter your cell phone number*

Please supply your cell phone number so that we may contact you in the event there are urgent questions regarding your exam.

Phone

Requested Date of Exam*

(Monday-Thursday)

Using the format MM/DD/YYYY

Requested Exam Time*

(Exam must finish by 5pm)

Using the format HH:MM

Duration of Exam*

Please enter in minutes

Can your student arrive early for their appointment?*

If yes, please specify the earliest time they can arrive. Example: 1:00 PM

Can your student arrive late for their appointment?*

If yes, please specify the latest time they can arrive. Example: 1:00 PM

Please Select the Allowable Materials*

Select all that apply.

Unless otherwise noted, all allowable (written) materials will be collected at the end of the exam.

Select

Other Allowable Materials*

Include whether notes (specify size), calculators (specify model), books (specify title & author), etc. are permitted.

Exam Type*

The exam is available in Canvas.

The exam is on paper.

File Upload*

Please upload a copy of the exam.

Drag and drop files here or

How would you like your exam returned?*

Emailed

Will Pick Up

Student to submit via Canvas

Send me a copy of my responses

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