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Proctor Service Request Form for Faculty of Online Courses

All fields are required.

Instructor:

Phone Number, including area code:

Semester:

Course Name:

CRN(s):

Number of Students:

All fields are required.

Date for Test 1: (mm/dd/yy)

Amount of Time Allowed:

Test Base:

Paper Based   Computer Based

Software:

All fields are required if a second test date is desired. If you do not wish to arrange a second test date please leave these fields blank.

Date for Test 2: (mm/dd/yy)

Amount of Time Allowed:

Test Base:

Paper Based   Computer Based

Software:

         

 

Testing Center
Elizabeth Bradley Turner Center, room 207
Hours: 8 a.m.-5 p.m. (Monday-Friday)
Ph: 706-507-8020
Fax: 706-568-2016

Text-only version

Questions/Comments?

Columbus State University
4225 University Avenue
Columbus, Georgia 31907
706-507-8800

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Last Updated: 9/30/09