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Day __ Night __ M__ T__ W__ R __ F__ S__ Time: ____ Center: ______
INSTRUCTORS NAME: ___________Course No: _____ Phone: ______
NAME OF TEST _____________________ TEST DATE______________
SPECIAL PROCEDURE (if any):
PLEASE SEND ENOUGH TESTS FOR ONE EACH
PLEASE CHECK OR FILL IN THE BLANK:
Time limit: ____YES ____ NO
If Limited, Maximum Time Allowed: _____ Minutes
Other Limits (please list): ________________________
Open Book: _____YES _____NO
Notes Allowed: _____YES _____NO
Calculator Allowed: _____YES _____NO
Check here if students need constant proctor:
___ Send event form!
RETURN
Please collect and return the tests as soon as possible to the instructor at:
Location: Center: _____ Bldg: ____ Room: ______
SPECIAL INSTRUCTIONS:
_________________________________
_____________________________________________________
PROCTOR: __________________ COMMENTS:
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