University College

1. Name:
2. Phone:
3. E-mail:

1. Course Subject & Number:
2. CRN:

1. Exam/Quiz #:
2. How many students need to take the test:
3. Time Expected for student to complete test:
4. Starting Date:
5. Starting Time:
6. Ending Date:
7. Ending Time:
8. Scantron: (Select "Yes" or "No") Yes No
9. Write on test: (Select "Yes" or "No") Yes No
10. Materials Permitted: Calculator, Dictionary, Scratch Paper, etc.
11. Reference Material: WebCT, Vista, Other
12. Special Instructions:

Materials will be available for pick up after 10am on the next testing day.