Instructor Cover Sheet - Stetson University



1495425153035Academic Success Center209 E. Bert Fish Drive ? Unit 8366386.822.7127 ? fax 386.822.7322stetson.edu/asc00Academic Success Center209 E. Bert Fish Drive ? Unit 8366386.822.7127 ? fax 386.822.7322stetson.edu/asc-349250-908054000020000Instructor Cover Sheet Approved testing accommodations and/or make-up examsRemind your student(s) to make an appointment 5 days prior to exam date. Fill out the following form completely to bring/email with exam. Remember to pick up your exams from the ASC during business hours Today’s DATE_____________________Instructor’s Name__________________________Course Number_____________________Cell Phone________________________________Student’s Name (required) ________________________________________________________Does this student have testing accommodations through the ASC? ? Yes? NoAmount of time allowed for exam for the class:____________ Date exam must be taken by ______________________________________________________Aids that are permissible (please check all that apply): FORMCHECKBOX No aids are permitted for this exam FORMCHECKBOX Calculator FORMCHECKBOX Textbook(s) FORMCHECKBOX Notebook/Notes/Note cards (circle if only one is permitted) FORMCHECKBOX Laptop Computer FORMCHECKBOX Dictionary FORMCHECKBOX Thesaurus FORMCHECKBOX Word processing FORMCHECKBOX Other__________________________Special Instructions: _____________________________________________________________If you have any questions about approved testing accommodations, please contact the Academic Success Center. As a member of Stetson University, I agree to uphold the highest standards of integrity in my academic work. I promise that I will neither give nor receive unauthorized aid of any kind on my tests, papers, and assignments. By my actions and my example, I will strive to promote the ideals of honesty, responsibility, trust, fairness, and respect that are at the heart of Stetson's Honor System.If I violate The Honor Pledge, I understand that the ASC will remove the testing materials, notify the faculty member, and report the academic violation to The Honor Council. Pledged:________________________ Date:________________Instructor MUST initial exam cover sheet when picking up exam: _________ Date ____________ASC Use OnlyDate Taken_____________ ID Checked FORMCHECKBOX Staff ______________ Start Time_________________ Maximum End Time__________________ Actual End Time______________ Staff________________Revised 10/25/2012 ORIGINAL: Academic Success Center COPY: provided to instructor upon request ................
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