EXAM LAB TEST FORM
LCCC Exam Lab
EEC 224
examlab@lccc.wy.edu
Phone: (307) 778-1274
Fax: (307) 778-4311
REQUIRED Instructor Information
Date:
Name:
Contact #:
E-mail:
Course Name/#:
Exam Name/#:
# of Exam Copies:
Exam Time Period
Maximum Time Allowed
Individuals Taking Exam
Exam Description
Regular Course Exam
Make-Up Exam
Telecourse/Internet
Student May Use
Textbook
NOTHING
Students with Testing Accommodations
Standard Time
Extended Time
Dictionary/Thesaurus
Scratch Paper (#)
Attach to Exam
Calculator
(please specify)
(please specify)
Notes/Cards
Computer
Roster Attached
Any Student Requesting Exam
Specific Students (see below)
Exam requests will not be accepted or
the exams administered for whole classes
that should be tested during regular class sessions.
Other Aids
Special Instructions or Accommodations
Exam Dates
Exam Pick-Up
Instructor
Signature
Proctor must have approval from instructor to extend
exam dates. E-mail notification is preferred.
(please specify)
Testing Platform
Lockdown Browser
LMS
Paper
Other Computer-Based Program
(password)
(password)
(please specify)
Print Form