Faculty Request For Proctoring form

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FACULTY REQUEST FOR PROCTORING
Please use this form to request proctoring for your fully online or hybrid courses as well as for make-up
tests/exams in your face to face courses. To be sure we fully understand your needs, please use one form per
test/exam.
Click here to enter text.
Instructor Email: Click here to enter text.
Instructor Phone: Click here to enter text.
Course Title, Number and Section: Click here to enter text.
Instructor Name:
Type of Exam:
☐ Regular Test or Exam
☐ Make-up Test or Exam
Testing Method:
☐ Online via FVCC Eagle Online
Password: Click here to enter text.
☐ Paper – please attach file
How shall the tests be returned to you (mail box, office, other)?
Click here to enter text.
☐ Other Specify: Click here to enter text.
Date Range: begin date Click here to enter a date.time Click here to enter text.
end date Click here to enter a date. time Click here to enter text.
Length of Time Allowed: Click here to enter text.
Resources to be PROVIDED TO STUDENT:
☐ Computer (with access to D2L)
☐ Scratch Paper
☐ Calculator
☐ Tables
☐ Other (specify)
Click here to enter text.
Resources Student is ALLOWED TO BRING IN FOR USE:
☐ Calculator
☐ Notes
Click here to enter text.
Click here to enter text.
☐ Textbook (specify)
☐ Other (specify)
Special Instructions:
Click here to enter text.
Student Names (names required for Make-up tests, otherwise optional):
Click here to enter text.
Please attach test/exam file if needed
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