Fillable montgomery college Assessment Center GERMANTOWN FACULTY TEST REQUEST FORM

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montgomery college Assessment Center GERMANTOWN FACULTY TEST REQUEST FORM

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The montgomery college Assessment Center GERMANTOWN FACULTY TEST REQUEST FORM form is 1 page long and contains:

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  • 29 check-boxes
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File type: PDF

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Montgom
ery College Assessment Center
/GERMANTOWN
FACULTY TEST REQUEST FORM
Professor’s Name:
MC Tel. No/Ext:
Day/Evening Tel. #:
Course No:
Name of Test/Quiz:
Date Test Begins:
Date Test Ends:
No. of test copies:
Time allowed:
Hours:
Minutes:
Please check if this is:
Regular Course:
Distance Learning Course:
Germantown tests will be delivered to: HT/314
BE/116 PK
RV TP/SS PICK UP
Students May Record Answers On:
Attach Class Roster or write:
Test copy
:
Name(s) and ID(s) of Student(s) to be tested:
*Indicate students requiring double time with an asterisk.
Scantron
:
Name
Student ID#
(required)
Date Test
taken
Staff
Initials
Blue Book (supplied by instructor)
Ruler:
Ruled Paper:
Other Specify
Student May Use:
Calculator: Basic Scientific Graphing Programmable
Instructor’s Notes and/or DSS Accommodations/Instructions
Dictionary: English Foreign Language
Scratch Paper:
Textbook/Ref Book Specify
Cards/Notes Specify
Computer/Software Specify
ASSESSMENT CENTER STAFF NOTES:
Diskettes
Other Aids Specify
Please do not re-use completed forms.
Professor’s Signature: __________________________________________________
Date: _______________________
Rev 10/13/2014
ASSESSMENT CENTER USE ONLY:
Test Received and entered by: _______________________
Date: ____________
Time:____________
Test Returned by _________________________________
Date: ____________
Time: ____________
Final Transaction: # of completed tests returned: ________
# of Incomplete tests returned: ________
Blended Course:
DSS Student:
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montgomery college Assessment Center GERMANTOWN FACULTY TEST REQUEST FORM

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Completed 1 March 2020

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