North Campus Testing Center
Des Peres Hall, Room 105
, 314-977-5176
RESCHEDULED EXAM REQUEST FORM
Prior to Completing this Form, please keep the following in mind:
- Instructor Submission: Contrary to the Out of Class testing Forms, we ask that thecourse instructor submit the rescheduled exam request form.
- Form Deadlines:Please submit form 2 business days prior to the exam date request. During finals and midterms, we ask that form are submitted with 5 business days notice.
- Form Completion:Please be sure all information, including date and time are marked.
- Space Limitations: In the event of space limitation, the Testing Center Staff may need to propose a time other than the one requested.
Course:
Student's Contact Information / Instructor's Contact Information
Name: / Name:
Phone: / Phone:
Email: / Email:
Requested
Day: / M T W R F / Requested
Date: / Requested Start Time:
(Exam completed between 8am-4:30pm)
Original
Exam
Date: / Minutes allowed to complete the exam: / 50 60 75 90
Other:
MATERIALS NEEDED BY STUDENT DURING EXAM (please check at least one box)
Nothing: / Basic Function Calculator: / ScientificCalculator: / Graphing Calculator:
Finance Calculator: / Formula sheet(s)
How many? / Open book: / Open notes:
Scantron Form Form no. / Notes on index cardsHow many?
****Please note that instructors may need
tosupply scantron to TC.****** / Other (e.g., computer for online exam)
DELIVERY METHODS
How will the exam be delivered to TC at least 24 hours prior to exam? Email to
Instructor Delivery Student Delivery (at the time of exam)
How will the exam be returned to you? Instructor Pick-Up between 8am-4:30pm Student Delivery
TC Delivery to dept. mailbox within 24 hours of completion-Indicate Location
GENERAL INFORMATION NEEDED
What should happen if the student has a question during the exam?
Reason for reschedule request
Signature / Date