All RCTC faculty wishing to utilize the Testing Center for make-up exams must fill out this
form and submit at least 2 BUSINESS DAYS prior to desired test date.
Student Name: ____________________________ID: ____________________
Instructor Name:__________________________________________________
Instructor Email:___________________________________________________
Course Name:_____________________________________________________
Length of time permitted for
Is the student allowed to reschedule? YES NO
Any student who does not show up for an exam more than twice in one semester will not be allowed to use
the Testing Center to make up exams for the remainder of that semester.
Is the student allowed to use a calculator during the exam?
YES, type: _________________________ NO
Is the student allowed to use books or notes during exam?
YES, specify: ______________________ NO
Will the student need to use the Scantron or other form of scoring sheet?
YES, type: ______________________ NO
Please write any additional instructions below, including method of test:
Please indicate how you would like the completed exam returned to you:
I will pick up exam from the Testing Center.
Please scan/email back to email listed above.
Please return form to:
Ursula Olson-Hernandez, Testing Center Coordinator, AT 209
Email: testing@rctc.edu
FOR OFFICE USE ONLY: Date Received____________ Confirmation Sent YES NO Staff Initials__________