Instructor Testing Form

Please complete this form at least 2 business days prior to the test date.

Student Name Student Name * First Last
Campus *

Campus North Mankato Faribault
Course *
Test *
Date the test must be taken Date the test must be taken * / MM / DD YYYY
Can the student take the test a day earlier? *

Can the student take the test a day earlier? Yes No
How many minutes are allowed for the other students in the classroom? *
What items is the student allowed to use on the test? *

What items is the student allowed to use on the test? NOTHING Notes Computer Handouts Textbook Calculator Other Other
Is the test on D2L?

Is the test on D2L? No Yes
Are you using any of the following?

Are you using any of the following? LockDown Browser Monitor (*must be disabled for students testing in the ASC) Other Other

The use of Respondus LockDown Browser is available in the Academic Support Center; however, we are not equipped to support Respondus Monitor. Instructors will need to disable Respondus Monitor for students testing in the ASC. In lieu of Monitor, the ASC will provide our standard testing protocol which includes periodically monitoring students via a live feed and video cameras. Students are also required to check personal items such as cell phones, computers, and jackets at the front desk. Thank you for understanding.
Special Instructions (Scantron sheet, etc.)
If the student has questions on the test, what phone number and/or email address will you be available at? *
How would you like the test returned?

How would you like the test returned? Mailbox Keep in the ASC Other Other
Instructor Name *
Email *
Phone Phone * - ### - ### ####
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