(For Staff use Only) Time In Job Number ____________ Office of Measurement and Evaluation of Teaching - Scanning Service Scanning Service Request Form Request Form OMET. Cathedral of Learning Alumni Hall B-23 G-33 M-F8:30 8:30a.m. a.m. 5 - 5p.m. p.m. M-F pitt.edu • Student Answer Sheets and Keys must be filled out with a #2 pencil Student Answer Sheets and Keys must be filled out with a #2 pencil • Make sure the Key bubble is completely filled on any keys submitted Make sure the Key bubble is completely filled on any keys submitted • Results returned electronically within 24 hours (excluding weekends & holidays) Results areare returned electronically within 24-hours (excluding weekends & holidays) • Contact tests@pitt.edu any questions or concerns Contact Us Us via via omet.pitt.edu with with any questions or concerns Please print clearly when filling out the • Please print clearly when filling out form the form Instructor Info Contact Person Info (optional) Name Name Department Course # Phone Phone E-mail E-mail Key Info (for multiple uses only) Form Info Type Test Survey/Questionnaire Test Name Use previously saved key The key that will be used will be based on the information provided on this form (Instructor Name,Department, Course #, and Test Name). Date Student’s in Testing Center Number of Questions Check this box if you have any students taking the exam at the Testing Center. If this exam has multiple versions, please write the versions(s) each student will use below. Special Instructions: