TEST ADMINISTRATION INSTRUCTIONS

							                        Assessment Services

                         Instructor Make-up Testing
                                 Proxy Form

    DSC Assessment Services administers make-up tests for individual students to meet
 course requirements. Assessment Services does not administer tests for Online Courses or
  entire classes. Due to limited staff, testing room space, and pre-scheduled testing, check
                    with the appropriate campus for hours of operation.*


 This form authorizes a proxy to deliver and/or pick up exams (DSC ID required). It will be
            kept in the instructor’s files and remain valid for one academic term.



Course: __________________________________________

Instructor: ________________________________________

Phone number or ext.: _______________________________

Email: ___________________________________________

Alternate instructor or DSC staff:

___________________________________________________________________________




 _______________________________________                       ________________
  Signature                                                     Date


*Some campuses require appointments for make-up exams.
                                                                  AS – 9/1/11