Request For Test Or Survey Scanning Form
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1R E Q U E S T F O R T E S T O R S U R V E Y S C A N N I N G
Detailed i nstructions f or t he p reparation, p ick-‐up a nd d rop-‐off o f m aterials a re o nline a t
Instructions:
Fill o ut a ll r equested f ields. I f y ou a re c ompleting t his f orm o n b ehalf o f a n i nstructor, e nter t he i nstructor’s
•
information b elow.
Print t he f orm. T he c ompleted f orm c annot b e s aved o r s ubmitted o nline. T he i nformation w ill b e l ost i f i t
•
is n ot p rinted.
Include o ne c opy o f t his p rinted f orm p er a nswer k ey w ith s cantrons.
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Place s cantrons i n a m anila e nvelope ( one e nvelope p er a nswer k ey).
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Do n ot s end s cantrons t hrough c ampus m ail.
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Do n ot u se s taples, p aper c lips, l abels o r r ubber b ands, w hich c an m utilate f orms a nd r esult i n d elayed
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processing a nd/or i mproper s coring.
Name:
Department:
Email:
Date:
P hone:
Choose O ne o f t he F ollowing:
T est S canning
S urvey S canning
Course # :
Section # :
Test V ersion # (if a pplicable):
G enerate B lackboard L earn I mport F ile
Special R equirements ( include p oint v alues):
Signature o f R equestor:
Please n ote t hat a ny s cantrons n ot p icked u p w ithin 6 0 d ays w ill b e s hredded a nd r ecycled.
Deliver e xams f or s coring t o:
IT S ervices H elp D esk
155 R azorback R d. A DSB 1 00A
Monday t hrough F riday, 7 a .m. t o 5 p .m.
FOR I T S ERVICES U SE O NLY:
Scan c ompleted b y:
Date:
_____________________________________________
______________________________
Picked u p b y:
Date:
____________________________________________________
______________________________
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Parent category: Business