Thank you for using the Mines Testing Center (MTC)!

The MTC is a campus entity available to faculty for exam administration, primarily to the accommodated student population.

Please contact MTC staff regarding other requests: testingcenter@mines.edu.


PDF versionText only version

PDF versionText only version

1) Complete the form below.

  • The faculty request form can now accommodate more than one exam date -- if possible, please submit all exam dates for the semester.
  • Please complete this form in full at least 7 days prior to the scheduled exam. 
  • The MTC staff will be in touch within 48 business hours to clarify details and/or confirm the exam.

 



MINES TESTING CENTER REQUEST FORM

Items with a star ("*") are required.

After you Submit your form, please scroll back down the page to check for any highlighted errors in your submission.

You will receive an auto-reply email upon submission of this form. Please read for further details.

If you do not receive an email confirmation, your request has not been made (errors on the page) and will not be processed by the MTC.

* Your Last (Family) Name:
* Your First Name:
* Your Email (Mines preferred):
* Your Phone Number:

If you are requesting on behalf of another instructor please list:
Name:
Email:

NON-ACCOMODATED EXAM INFORMATION
(regularly scheduled time/regularly scheduled length)

* Is this a short notice request (less than 7 days from exam)?
Yes
No
* Is this a make-up exam?
Yes
No
* Is this an accommodated exam (for a student with a disability)?
Yes
No
* COURSE NAME (e.g. CSCI101)
* Non-Accomodated Exam DATE
* Non-Accomodated Exam START TIME (HH:MM AM/PM):
* Non-Accommodated Exam END TIME (HH:MM AM/PM):

MTC REQUESTED EXAM INFORMATION
(Accommodated Exam)

* Requested Testing Center Exam Date:
* Requested Testing Center Exam START Time (HH:MM AM/PM):
Students must stay in the MTC until the following time (e.g., released after the rest of the class has begun):

DURING THE EXAM:
By law, someone must be available for questions during the exam.

* CONTACT PHONE NUMBER (preferably a cell number):

PERMITTED technologies or materials (e.g., calculators, scratch paper, specific books, etc.)?
PROHIBITED technologies or materials:
Additional Information (please note any addition details, requests, or notes here):

PRE-EXAM MATERIAL DELIVERY:
* Sufficient copies of the exam will be:
Delivered to the Testing Center Coordinator Office (Wellness Center 209)
Delivered to the Testing Center Location (Stratton 109)
Emailed to testingcenter@mines.edu (Testing Center will print appropriate number of exams. Printed exams will not be cleared by instructor prior to the test.)

Reminder: All exam materials, including supplemental information, are kindly requested at least ONE (1) business day before the exam (e.g. Friday delivery for Monday exam).

SUBSEQUENT EXAM DATES FOR THIS COURSE:

The information listed on this form may be applied to these additional exam dates (same course, same students):

Subsequent Exam Date #1:
Subsequent Exam Date #2:
Subsequent Exam Date #3:
Subsequent Exam Date #4:

POST-EXAM DELIVERY:
* Following exam completion:
Completed exams will be delivered to the following office location
Completed exams will be picked up by instructor (or designee)
Building and room number for delivery if chosen above:
Please list a backup delivery location (Departmental office):
Number to call upon exam completion (if pick-up was chosen above):

STUDENTS EXPECTED AT TESTING CENTER EXAM:
Please provide full names (First and Last):

Student #1 Name:
Student #2 Name:
Student #3 Name:
Student #4 Name:
Student #5 Name:
Student #6 Name:
Student #7 Name:
Student #8 Name:
Student #9 Name:
Student #10 Name:
Student #11 Name:
Student #12 Name:
Student #13 Name:
Student #14 Name:
Student #15 Name:
Student #16 Name:
Student #17 Name:
Student #18 Name:
Student #19 Name:
Student #20 Name:

After you Submit your form, please scroll back down the page to check for any highlighted errors in your submission.

You will receive an auto-reply email upon submission of this form. Please read for further details.

If you do not receive an email confirmation, your request has not been made (errors on the page) and will not be processed by the MTC.


If you have any questions or concerns, please contact the Testing Center at testingcenter@mines.edu.



* required