Instructions:
Please complete all fields on this form. When you press submit, your request will be forwarded to your requested proctor at the email address you provide. You will also receive an email receipt of your request.

Proctor Approval Request
Student Information
Name:
Student ID:
Current Location:    
City Military Base (optional) State   Zip Code
Email Address:
Work Phone:
Home Phone:
Employer:
Occupation or Rank:
Campus:
Other Campus:
Advisor:
Term:
Course(s) in which exam(s) will be proctored: eg Course ID: HIST1303 Section: VC01
 
Course ID:
 
Section:
 
 
Course ID:
 
Section:
 
 
Course ID:
 
Section:
 
Proctor Information
Name:        
Email: Please check here if proctor is on a military base