Exam Day Information Form
Please provide your details and information about your exam day experience.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Exam Name or Subject
*
Exam Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Exam Location (Building/Room)
*
Seat Number or Assignment
List any materials you are bringing (e.g., calculator, ID, stationery)
Do you require any special accommodations for the exam?
*
No
Yes (please specify below)
If yes, please specify your special accommodation needs
Emergency Contact Name and Phone Number
*
How satisfied were you with the exam day organization?
*
Not satisfied
1
2
3
4
Very satisfied
5
1 is Not satisfied, 5 is Very satisfied
Please rate the following aspects of your exam day experience:
*
Rows
Check-in Process
Exam Room Comfort
Clarity of Instructions
Staff Helpfulness
Poor
1
2
3
4
Fair
5
6
7
8
Good
9
10
11
12
Very Good
13
14
15
16
Excellent
17
18
19
20
Additional Comments or Suggestions
Submit
Should be Empty: