Monroe County Community College
Instructions for Make-up or Distance Learning Course Testing
Please fill out
one form for each test submitted. We require photo identification for all students. Tests will be administered according
to these instructions so please be careful to list any special instructions or materials allowed. After completing this form, please keep
the pink copy for your file. This form (white & yellow copies) must be turned into the RCTC (Z-258) along with the test(s).
Instructor’s Name: *Student’s Name:
Office Phone #: Ext. #: Home Phone #:
Course No./Name:
Student(s) may take test from through
(Date) (Date)
Test name: Timed Test (Time Limit):
Instructions/Materials allowed (9 items allowed):
write on test use answer sheet provided blank paper calculator
dictionary foreign language dictionary notes scantron
textbook (specify title)
other, please specify
Special instructions: ___________________________________________________________________
* Class list is attached for the Video and Distance Learning Classes.
Date the instructor will pick up completed tests: (All tests are held for instructor pick up)
Instructor’s Signature:
Copies: White, returned with completed test; Yellow, RCTC File; Pink, test originator/instructor Saved as Testing Form for e-mail2018.pdf
