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Proctor Request Form

This is not a secure page. You may request a proctor online by filling out and submitting the proctor form below.

1.  Please review Qualifications for Proctors before completing this form.

2.  All proctored exams must be administered in an educational or professional setting .
 
3.  Students are not allowed to use personal computers or laptops for proctored tests.

4.  A new form must be submitted for each test to be proctored. Please remit form one week prior to test date.

5.  If testing at an LCSC Outreach Center, NIC Centers CDA, Bonner’s Ferry, Sandpoint and Silvervalley, you DO NOT have to fill out a proctor request.

Either the student or the proctor may fill out this form.
All fields are required unless noted.


Student Name:


Student LC Mail Username:
@lcmail.lcsc.edu


Course Title and No:


Instructor Name:


Exam needed:


Proctor Name:


Proctor Title:



Proctor's Official E-mail Address:


Verify Proctor's E-mail Address:


Proctor Business Name:


Proctor Mailing Address:


Proctor Daytime Phone:


Proctor Daytime Fax:


Relationship to student:


Numbers of years known:

  


If you have any questions or concerns,
please don't hesitate to call 800-879-0458 or e-mail
dl@lcsc.edu.

 

Lewis-Clark State College
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500 8th Avenue • Lewiston, ID 83501 | (208) 792-5272 • (800) 933-5272
LCSC is accredited by the Northwest Commission on Colleges & Universities 8060 165th Avenue NE, Suite 100 Redmond, WA 98052-3981