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    CBC Exam Check Sheet for Accommodation Examinee who needs to have their exam/(s) administered in the
    CBC Testing Department.
     

      

      

    Instructor’s Name:  

      

    Instructor’s Phone Number: 

       

    Instructor’s E-mail Address: 

       

    Please provide so that the Testing Personnel can contact you if they have any questions concerning your exam instructions.  

      

      

    Select the CBC Test Site:  

      

              

     

      

      

    Course Name:  

       

    Course Number with section#:  

       

      

      

    Accommodation Student’s Name:  

       

    Student’s CBC ID#:  

       

      

      

    Enter the type of accommodation/(s) needed for the examinee:   

        

    Please remember to have the examinee come to or call the appropriate CBC Testing Center to schedule their appointment to test. This needs to be done at least two (2) business days in advance of when they want to test.  Below is the contact information for each test site.

    Alice Site:  (361) 664-2981 Ext: 3045
    Beeville Site:  (361) 354-2334
    Kingsville Site:  (361) 592-1615 Ext: 4070
    Pleasanton Site:  (830) 569-4222 Ext:  1201

    The examinee must present Photo ID – such as a CBC ID card or Driver’s License when they come in to take the exam.  An exam will not be administered without proper ID.
     

      

      

      

    Select the Mode of Testing: 

       

               

     

    Begin date of test: 

       

    Begin time of test: 

       

    End date of test: 

       

    End time of test: 

       

    Amount of time allowed for exam:  (Example:  1 hour / 2 hours/ 75 minutes)  

       

    Exam #:   

       

    Select which of the following aids may be used.  If no aids, select the option – No aids allowed. 

      

     

     

    Password – (for Blackboard, Respondus, etc…. exams): 

      

    Special instructions for proctors:   

        

      

      

      

      

       

      

      

      

      

      

    Instructor initial here stating that you have read and understand the following:
    It is your responsibility to do the following at least two (2) business days before the exam should be administered.  This is mandatory.
     

      

    Initial that you have read and understand the following: 

    Instructor - e-mail a scan of the signed Accommodation Form showing what has been approved.  E-mail the scan to: CBCProctor@coastalbend.edu 

    Initial that you have read and understand the following:  

     
    For the screenreader software to read the exam aloud to the examinee - the exam needs to be sent to the Testing Department as a .doc (Word) electronic file.  E-mail it to CBCProctor@coastalbend.edu  

    If you have a pdf of the exam - you need to go to Adobe Acrobat X which should be on your computer - Open the pdf document then go to File - Save As - Word - then name the file.  Then you will send the Word document as an attachment to the Testing Department.
     

     

     

     

    Page created 2/28/17
    Page revised 4/6/17