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DSS Instructor Test Form
Library 215
Hours 8 - 12 p.m. and 1 - 4:00 p.m.
Date:
(mm/dd/yyyy)
Instructors name:
Course:
Phone:
Students names:
Date and time test is to be completed:
Time allowed for test:
May use notes:
Select One
Yes
No
May use book:
Select One
Yes
No
May use calculator:
Select One
Yes
No
Return by:
Intercampus Mail
Instructor Pick Up
Student Delivery
Select which one applies to this exam.
Accommondations requested:
