Please submit this request at least 4 business days from the scheduled exam time. This is NOT the form for requesting an exam through Disability Services. Once the form is complete it will be printed out and signed before the exam. Course & Instructor Information Course Name Student First Name Student Last Name Student Access ID This is not your 9 digit psu id. Example: abc123 Instructor First Name Instructor Last Name Instructor Email Instructor Cell/Office Number (In the event that there may be questions during the exam) Exam Information Instructor may be required to show photo ID when picking up exam at Lilley Library Circulation Desk. Exam Type - Select -Makeup Exam/QuizMakeup Final Exam Materials Permitted Pencil/Pen Only Open Book Open Notes Calculator Scratch Paper Others (including software) Special Software Required Special instructions Days and hours of availability for Spring 2024: Wednesday: 1:00 pm - 4:00 pm Friday: 9:00 am - 12:00 pm Date of Exam Time Exam is to Begin Duration of Exam (in minutes) Delivery of Exam Exam/quiz will be emailed to Testing Center Exam/quiz will be hand delivered to Reed 1 in the Reed Union Building We will NOT send exam/quiz through campus mail Return of Exam Note: A scanned copy of the exam will automatically be sent to the instructor's PSU email address. Please select a method to retrieve the physical copy of the exam(s). Instructor will pick up exam/quiz from Reed 1 in the Reed Union Building Proctor Information To be completed by Testing Center Proctor First Name Proctor Last Name Date of Proctored Exam Time Exam Began Time Exam Ended Notes from Proctor to Instructor Student Information To be completed by the student CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit
