Request for a Proctored Examination

The GenEdWeb Program requests that you choose a proctor from the following list of options:

  1. a school superintendent, principal, or counselor
  2. a clergy member
  3. a faculty member (excluding teaching assistants) or administrator of an accredited university, college or high school.
  4. a head librarian
  5. a commissioned officer whose rank is higher than your own (for students in the military only)
  6. a corporate education director
  7. Coordinate Campus Continuing Education Office (see proctor exam policy listing for office locations)

The GenEdWeb Program verifies all proctors and reserves the right to give final approval.

PLEASE FILL IN ALL FIELDS ON THIS FORM:

Student's Last Name Student's First Name MI



Telephone
Email
Stree Address
City State / Region
Zip

Course



SELECT ONE PROCTOR OPTION:

I live in Morris, and I will take my proctored exam in the Continuing Education office at UMM, 105 Blakely Hall. (See the GenEdWeb exam policies web page for contact information to schedule an appointment for your exam.)

I do not live in Morris, and my proctor's contact information is listed below. I have already contacted my proctor to confirm they are willing to administer this exam.
Proctor's Last Name Proctor's First Name Proctor's Office Proctor's Title





Proctor's Email
Proctor's Telephone Number
Proctor's Fax Number
Proctor's Address
Proctor's Address 2
Proctor's City Proctor's State / Region
Proctor's Zip

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Last Modified: Thursday, November 05, 2009
Page URL: http://genedweb.morris.umn.edu/courses/ss/exam_form.shtml