Proctor Request Form

Proctor Request Form

INSTRUCTIONS: THIS FORM IS TO BE COMPLETED AND SUBMITTED BY THE COURSE INSTRUCTOR. If there are multiple exams for one student, one form must be submitted per exam.
Testing Center

Instructor please enter this information on the student's behalf:
Final Date Exam Can Be Proctored*

MonthDayYear
Hours of Operation: Tuesday 10- 3 | Thursday 10 - 3
Student's Park ID#*
Information entered by instructor
Student's Name*

First NameLast Name
Course number*
Instructor's Name*

PrefixFirst NameLast Name
Instructor's Contact Number*

Area CodePhone Number
Instructor's Park E-mail*
All exams will be emailed back to the instructor to the Park-Email address provided above.
Exam instructions

Instructor please fill out all the information below
TIME ALLOWED FOR THE TEST: (This time should reflect the original time allowed for all students to take the exam. The Testing Center will adjust according to accommodations approved if needed*
Ex. 30 min, 45 min, 1 hour, etc.
If the student reaches the time limit and still has questions left, do you want to allow EXTRA time to finish the exam?*

YesNo
If yes, how much EXTRA time do you allow?*
Ex. 10 min, 30 min, 45 min
Does the student have testing accommodations?*
Calculator*
Open book*
Open notes*
Is this a computer based test or a paper test? *
Is the student taking the exam through canvas? *
Enter password for canvas*
Are there additional instructions for the exam? Answer N/A if there are none*
Upload a copy of the exam. If there are multiple exams please complete one form per exam*

Browse Files

Cancelof
Please advise your students to make an appointment with the Testing Center, at least 24 hours prior to taking their exam by registering for the test at https://www2.registerblast.com/park

In addition, students will need to present a photo ID is needed on test day!
Should be Empty:

Proctor Request Form

Testing Center

Instructor please enter this information on the student's behalf:

Exam instructions