Student Test Proctoring Request Form

If your instructor is unable to proctor your exam with accommodations, you may request to take the exam in the Learning Access Center. Please note that requests must be received at least three business days before the requested date.

Your Name *

Name of individual making request.

Your email address

Course and Number *

Example: ENG 100, CHY 141, MAT 151

Instructor's Name *

Please use your syllabus if you're not sure how they spell it.

I have discussed my accommodations for this exam with my instructor. They cannot proctor the exam with accommodations, so we are requesting it be proctored. *

Yes

No. (If this is the case, do not continue. Please contact them immediately as they may be able to proctor the exam with accommodations)

Check one

Date of exam *

When would you like to take the exam? You should consult with your professor to see when they want you to take it.Please note we may note be able to accommodate the exact time or date requested.

Time exam starts *

According to your instructor, what time does this test begin?

Do you require a computer as an accommodation for your exam?

Yes

I understand I must wear a mask at all times while testing if mask mandates are in effect on campus

Yes

I understand I should only bring with me what I need for the exam and nothing more as storage space is limited.

Yes

I understand that when I arrive at Franklin Hall I must report to the UMF Testing Center on the 3rd Floor, where the test will be proctored

Yes

I understand that no food or drink, including snacks and water bottles, are allowed in the testing labs.

I understand

Please let us know accommodations that you receive that need to be arranged for this test.

If you are human, leave this field blank.

Student Test Proctoring Request Form

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