Frost Campus Testing Center
Des Peres Hall, Room 105
, 314-977-5176
RESCHEDULED EXAM REQUEST FORM
It is the course instructor’s responsibility to submit this completed form to the Testing Center (TC) at least two business day prior to the requested exam date (one week prior for midterms/finals). Please be sure all information, including date and time are marked. In some instances,TC staff may need to propose a time other than the one requested if schedule or space conflicts exist.
CourseName
Number / Instructor Name
Student Name / Email
Email / Number
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 / __ / Scientific
Calculator / __ / Graphing Calculator / __
Finance
Calculator __ / Formula sheet(s) __
How many? ______
/ Open book / __ / Open notes / __
Scantron Form __ Form no.______/ Notes on index cards __ How many?______
****Please note that instructors may need
to supply scantron to TC.****** / Other ______
(i.e.TC computer for Excel or Blackboard)
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 ______
TESTING CENTER NOTES
What should happen if the student has a question during the exam?______
Reason for reschedule request______
Signature / Date