Daily Run Times 9:30 AM & 2:00 PM
Instructor’s Name (Last) _________________________________
Date submitted: __________________ Due date: _____________________
NOTE: Test not picked up by “Grade Submission Date” for the current semester. Will be sent to the Provost Office.
Course acronym, number and section: _________________________________________________
Number of questions on answer key: ______
Number of answer sheets ______ (Not counting key)
Special instructions: _______________________________________________________________
To save paper, results are only printed when requested. If you need hard copies, check the reports
that you want printed.
____ 101 Student Statistics Report
____ 104 Test Statistics Report
____ 207 Test Item Statistics Report
____ 301 Student Grade Report (Student Results, 1 page per student)
____ 204 Condensed Item Analysis
__________________________ ________________________
Picked up by Date picked up
Test reference:
Day - M T W R F
Week - A B C D E F G H I J K L M N O P
Test # - 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
31 32 33 34 35 36 37 38 39 40 41 42 43 44 45
46 47 48 49 50
Revised 1/16/19
Use a regular answer sheet for your key. On the answer sheet under NAME, enter
KEY_INSTRUCTOR’S USER NAME using a #2 pencil. Example: KEY_SMITHJ
Fill in answer sheet with the correct responses. When changing an answer, please make sure to
thoroughly erase the old answer.
To omit a question, leave all bubbles blank for that question.
You may submit more than one possible answer for a question.
Example: To submit both A and B as correct answers, fill in the appropriate bubbles for each.
Make a note in the special instructions if “must have” multiple answers are required for the
question to be considered correct.
To give credit for any response, fill in all of the bubbles for that question.
On the answer sheets, students should fill in Name: LAST_FIRST with the corresponding circles
filled in for each letter. Check to make sure students bubble in their name; otherwise, the
reports will have no name listed for that student. Leaving the space between names will make it
easier to read the reports.
Answers crossed out on student answer sheets are counted as incorrect. Although the answer
sheet indicates black or blue pen is acceptable, have your students use a #2 pencil to allow
for erasure.
DO NOT USE Liquid white-out
When submitting tests, keep answer sheets neat and clean and all going in the same direction.
Be sure to remove all blank sheets. Blank sheets affect the test statistics report.
Use only one envelope when you have more than one test to submit unless it is a large class
and/or print outs are requested.
Please be sure to retrieve your scanned forms even though the results are e-mailed to you.
Per FERPA guidelines, we cannot dispose of them.
This form is available online in a fillable format. From the Stockton homepage, click site
map, click e-forms, and go to Information Technology Services, Test Scoring Request Form.