Scantron Job Request Form
Learning Technologies can only score the ParScore form F-1712. Forms must be filled out with a #2 pencil. You must specify a
test form (A, B, C or D) on the key and on each test form. If there is only one version, specify form "A." Normal turnaround time is
two working days. The charge for Scantron scoring is $10 per hour for the use of the equipment, plus $15.00 per hour for student
staff time (pending availability), or $62.00 per hour for regular staff time. All students must bubble in their student ID number and
their name or the scanner will not score their test.
Date of Request:
ASAP
Date Needed:
Instructor Name(s):
Phone Number(s):
Email Address(es):
Department/Course Number:
FOAPAL Number:
Organization
Program
Activity
Fund
Account
Financial Assistant:
Billing Address:
Raw
Percent (available only for By Last Name report)
Without Grades
Display Score as:
Course Enrollment:
Hand Count:
Number of Answer Keys:
Treat Multiple Marks as:
And
Or
None
(Click to select one only)
(Click to select one only)
Reports
E-Mailed
Special Requests
Scan by Section
PDF
TXT
CSV
CSV
# Sections:
Bonus Questions
By Last Name*
R
P
WG
(List by Answer Key)
Score Distribution and Histogram
D
H
A:
Item Analysis
A
B
C
D
Student Test
B:
WG
(printed 1 or 2 students per page)
C:
Student Response (comma-separated data)
Roster Spreadsheet (comma-separated data)
WG
D:
eCommons (comma-separated data)
NOTES
Weighted Questions
(List by Answer Key – attach
additional info if necessary):
A:
B:
C:
Learning Technologies Staff Use Only
Course Number as entered in ParScore:
Number of forms scanned:
Staff -
Name of staff scanning forms:
D:
Student -
# Hours scoring exam (to nearest .25):
Recharge Reference Number: