Proctoring Request Form - Newark Campus
Faculty are required to submit a test proctor form for each student for each test.
Newark Contact Information
Front Desk- 740-366-9417
Email-
NWK-testingcenter@osu.edu
Student Information
Student Name
*
First Name
Last Name
Student Name.#
*
(i.e. smith.1234)
Test Information
Exam Name:
*
(i.e. Week 3 Quiz, Midterm, Exam 2)
Course Name & Number:
*
(i.e. Math-1050)
Due Date:
*
-
Month
-
Day
Year
Date
Class time allotted for test:
*
Additional time for students with accommodations will be calculated at the time the test is given.
Instructor authorizes (Select all that apply)
*
Open Book
Open Notes
Formulas/Tables
Computer
Nothing
Calculator
Other
Reason student is taking test in the Testing Center:
Mandatory make-up test
Missed classroom test
Accommodations
Placement Testing
Type of Calculator
Special instructions:
Instructor Contact Information
Instructor Name
*
First Name
Last Name
Instructor Email
*
name.#@osu.edu
Contact Phone #
*
Preferred method of contact:
*
Email
Phone #
Test located on (Select One)
*
Paper
Computer
Answer Sheet
*
Write Answers on test
Scantron Form 889-E (Green, 25 questions per side)
Scantron Form 882-E (Green, 50 questions per side
Lined paper for essays
Computer
Attach a digital copy of your exam(s).
Browse Files
Cancel
of
Return of test (select one)
*
In-person: The testing center staff will email a notice to the instructor stating the test is complete and ready for pick-up by the instructor in Warner Center Room 206
Online Delivery: Completed test will be scanned by testing center staff and sent by email to the instructor's college email address
Submit
Should be Empty: