EXTENDED TIME TESTING FORM
DISABILITY RESOURCE CENTER
LOG # __________
SECTION A – completed by STUDENT
STUDENT NAME:______________________________________________________ ID#:__________________________________
COURSE:_____________________________ (Example: Math 1101) INSTRUCTOR:_______________________________________
CAMPUS TEST IS TO BE TAKEN AT: ______________ TEST DATE: ______________ TEST TIME: ______________
I have read and will follow the Responsibilities and Procedures on the back of this form______________(Initial here)
SECTION B – completed by INSTRUCTOR
NOTE TO INSTRUCTORS:
Each test must have a DRC Testing Form attached
Once a test date is scheduled with DRC, it cannot be changed without Instructor’s written permission
If this test is not completed within 48 hours, it will be returned to the instructor
Instructors can email or hand-deliver tests and testing forms as follows:
MAIN CAMPUS
[email protected]
Room SSC 209
WS CAMPUS
[email protected]
WSII Room 113 (Assessment Center)
JMMC CAMPUS [email protected] Room TW 203 (Assessment Center)
Verify Number of Pages in Test: ______________
Instructions
Yes
224-3259
224-3259
224-5946
Instructor Contact: ______________________
No
Additional Instructions:
Calculator
Open Book
Notes
Collect Notes
May Write on Exam
Scantron
Collect Scratch Paper
What amount of time will the class be given for this test? ______________hour(s) ______________minutes
WHEN TEST IS COMPLETED, HOW WILL TEST BE RETURNED?
INSTRUCTOR WILL PICKUP TEST
SOMEONE OTHER THAN THE INSTRUCTOR WILL PICK UP TEST (MUST PRESENT PICTURE ID) NAME:
THE EXAM IS TO BE TAKEN ON THE COMPUTER AND ELECTRONICALLY SUBMITTED.
INTEROFFICE MAIL* to: (room #)
at: (campus)
(division)
* PLEASE NOTE: FINAL EXAMS WILL NOT BE SENT INTEROFFICE MAIL; All tests sent interoffice mail will also be scanned and emailed to
Instructor’s CNM email address to prevent complications due to loss or delay
SCAN AND EMAIL COMPLETED TEST (to CNM.EDU email address only) * PLEASE NOTE: it may take up to 24 hours for scan and email return
INsTRUCTOR SIGNATURE: ________________________________________________________ DATE:
____________
SECTION C – OFFICE Use Only
Student started test
Date: __________ Time: ___________
Employee’s Initials: __________
Student completed test
Date: __________ Time: ___________
Employee’s Initials: __________
Instructor picked up test
Date: __________ Time: ___________
Instructor’s Initials: __________
Placed in interoffice mail
Date: __________ Time: ___________
Employee’s Initials: __________
Scanned and emailed to Instructor
Date: __________ Time: ___________
Employee’s Initials: __________
Test not taken at DRC; sent back to instructo
Date: __________ Time: ___________
Employee’s Initials: __________
When test in the pick-box has not been picked up notify the instructor
Talked with instructor OR left message
Date: _______
Time: ___________
Employee’s Initials: __________
Test Taking with Accommodations
Student Instructions, at least 5 business days before the test:
Step 1: Obtain an Extended Time Testing form by:
a. Coming by the Disability Resource Center, OR
b. Printing the form out at https://www.cnm.edu/depts/disability-resource-center/forms
c. Complete a Special Request Form if you need an Interpreter, Reader, or Scribe for your test.
Remember that tests with an Interpreter, Reader or Scribe may need to be scheduled on Fridays
Step 2: Call or come by the Disability Resource Center to schedule the test
Step 3: Fill out Section A of the form
Step 4: Give the Extended Time Testing form to your instructor
Step 5: Arrive at Scheduled Room at scheduled time (see below for Rescheduling)
Instructor Instructions:
Step 1: Receive the Extended Time Testing form from the student with Section A completed
Step 2: Complete and sign Section B of the Extended Time Testing form
Step 3: Submit the Extended Time Testing form with the test (see front of form for options)
a. Tests not taken will be returned to Instructors after 48 hours (see below for Rescheduling)
Rescheduling a Test:
Students must take the test at Disability Resource Center at the date and time on the Extended Time Testing
form. Should you not be able to take the test at that time, you must:
a. Ask your Instructor if it’s okay to take your test at another time, if so,
b. Instructor must notify DRC in writing that the student is approved to take the test at another time
c. Student must contact the Disability Resource Center Office to cancel and / or reschedule the test.
Reminders about taking tests at Disability Resource Center:
1. All personal belongings (ex: backpacks, purses, hats, cell phones, etc.) will be locked in a cabinet. You
2.
3.
4.
5.
6.
cannot take these into the testing room with you.
Only materials specified by the instructor are allowed in the testing room with you (ex: textbooks, notes,
dictionaries, etc.).
Personal calculators are allowed only when specified by your instructor.
All food and drink must be in clear containers.
Pens, pencils, erasers, and scratch paper will be provided by the Disability Resource Center Office.
Scantrons and Blue Books that you bring in for your test will be exchanged with Scantrons and Blue Books
provided by the Disability Resource Center Office.
Breaks will be supervised. You will have a Disability Resource Center escort for bathroom breaks.
7.
8. Testing while listening to music will take place in DRC testing rooms. (Those students who want to
test with music and attend a different campus will have to schedule their tests at one of the DRC
test centers. Music devices limited to Pandora or radio provided by the DRC. Radio is only
available to students at Montoya and Main.)
9. Testing rooms are monitored; any academic dishonesty* or violation or the rules stated above will
result in the test being ended immediately and your Instructor being notified. Continuation of the test
will be determined by the Instructor.* CNM Student Code of Conduct, § III. Academic Dishonesty, “Any student suspected of academic
dishonesty will be subject to the investigative and disciplinary process outlined in the Academic Dishonesty Policy found in the Student Handbook.”
Rev 7/7/16