Distance Testing Proctor Request

Professor Name

Professor Email Address

Professor Phone Number

Name of Institution

First Name, Last Name and Email Address

Please enter a valid institutional email address for students to receive official communication. Please separate students by creating a new row for each.

Exam Name

Course Prefix and Number

Exam Start Date

Exam End Date

Time Restriction

• Allotted time must not exceed 8 hours.
• Unlimited time on exams is not permitted as our Testing Center is appointment-based.
• If submitting a request for a student with time accommodations, please enter the total time including accommodation approved by your institution. I.E. If the normal testing time is 1 hour but the student has an accommodation for double time (2x), please enter 2 hours.

If a student requires special accommodations based on a documented disability, please include the accommodation(s) needed below.

Please indicate which application(s) the exam requires. I.E. LockDown Browser, Canvas, MyMathLab etc.

If none, please put 'None' in the box below.

Exam Password (if applicable)

Exam Resources and Materials allowed: (notes, scratch paper, calculator, charts, etc.)

Any items not listed here will not be allowed during the exam. If none, please put “None” in the box below.

Additional Instructions

I will assume responsibility ensuring that any and all applicable policies and guidelines from Valencia College and my institution are followed during the exam. I have read and agree to the Instructor Guidelines for Distance Testing.