STATE OF CALIFORNIA - STATE AND CONSUMER SERVICES AGENCY
ARNOLD SCHWARZENEGGER, Governor
BOARD FOR PROFESSIONAL ENGINEERS AND LAND SURVEYORS
2535 Capitol Oaks Drive, Suite 300, Sacramento, CA 95833-2944 Telephone: (916) 263-2222 CALNET: 8-435-2222 Facsimile: (916) 263-2246 www.dca.ca.gov/pels
DESIGN AND MULTIPLE-CHOICE COMMENT FORM
Examinee Name:______________________________________________________________________ (print or type) Last Name First Name MI Examinee Identification Number:_______________________________________________________ Test Location: _______________________________________________________________________ Directions: This is your form to be used for challenging specific test items in the Design and/or Multiple-Choice portion of your examination. Your comment(s) must be directed towards the ambiguity or validity of the design or multiple choice item. Your comment(s) will be reviewed by a review committee prior to the scoring process . Any response or item changes resulting from this review will be made prior to the scoring process in order to treat the entire examinee population fairly. Submission of a comment form does not constitute a personal appeal. You will not receive a response pertaining to your comment(s). Use one form per test question. For a question you would like to comment on, indicate the question number or type of problem and your comment. You must provide sufficient information regarding the question for the reviewers to locate the appropriate question and to fully understand your comment. Your comments must be submitted to the Board office, address shown above, postmarked no later than 10 days from the date of the examination. TEST DATE: ___________________________EXAMINATION: ____________________________ QUESTION:___________________________________ COMMENT: ________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________