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
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
Either the student or the
proctor may fill out this form.
All fields are required unless noted.
Student LC Mail Username:
Course Title and No:
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,
don't hesitate to call 800-879-0458 or e-mail