Coastal Bend College Testing Verification Form
    Fill this form out only if you are at a Coastal Bend College testing center (or an approved testing location) and are taking an exam that is being monitored by our approved testing staff.

    This form will let your instructor know when and where you test when you come in for your internet/make-up/special accommodation/correspondence exams.

    Also, you must fill out this form if you utilize the Beeville (Dirks-123)  Testing computer lab. We are keeping track of how often our testing computer lab is utilized and by how many people. 


    1.  Enter your first name  


    2.  Enter you last name  


    3.  Enter your CBC Student ID number  


    4.  Enter today's date by clicking on the calendar to the side 

     [None] Select a Date Delete the Date 

    5.  Enter the time you finished the exam/event/class 


     6.  Select the type of exam/event you took 


    7.  Enter the name of your course/event 


    8.  Enter the number of the exam - Example:  Exam 1, Exam 2, Unit 1, Midterm, Final 


    9.  Select the name of your Instructor/Presenter: 


    9b.  If your instructor's/presenter's name doesn't appear in the list above, please enter it here 


    10.  Select the location of your testing center 


    10b.  If you selected Other - Enter the name of your testing location here 


    11.  By entering my name once again in this field I am stating that the above information is correct and that I understand that this information will be available to my instructor/presenter for testing/event verification.  Enter you complete name here 




    Form created on 3/1/12
    Revised 5/15/20
    (Coastal Bend College does not disciminate on the basis of race, creed, color, national origin, gender, age, or disability.)