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Proctor Request Form
Please complete the following form for each test you wish to have proctored in the Testing Center. For paper tests, please bring printed copies and other necessary supplies (including scantron sheets) to Room 508.
Faculty Information
Faculty Name
Contact Phone Number
Alternate Phone Number
Email Address
Test Information
Name of Student (or upload roster below)
Roster Upload (pdf, doc, xls, or csv file)
Drop files or click here to upload
Additional Roster Upload (pdf, doc, xls, or csv file)
Drop files or click here to upload
Course Code
Course Name
Test Name
Testing Window Dates
Test Format
Paper/Pencil
D2L Respondus Lockdown
KAPLAN
FISDAP
Electronic - Other
Time Limit
Password (if applicable)
Materials Allowed
Scratch paper
Calculator
Notes
Other
None
Collect Scratch Paper
Yes
No
N/A
Ok to return completed tests by a work-study student
Yes
No
N/A
Other Instructions
Verification
Answering the captcha is required to proceed
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