Proctored Exam Request Form
If you are in need of a proctored exam, please fill out the below request.  Please, read the Proctor Policy  before filling out the below form.
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Name *
(First & Last)
Phone Number *
Email
(Optional)
Name of Exam *
What exam are you taking?
When is the exam due?
How long is the exam?
Is there a time limit?  If so, what is it?
What is your first choice for an exam date? *
MM
/
DD
/
YYYY
What time would you like to take the exam? *
Time
:
What date is your second choice? *
MM
/
DD
/
YYYY
What time would you prefer? *
Time
:
What is your third choice for a test date?
What time would you like to take the exam?
Time
:
Is the exam online or on paper? *
Name of the school, institution, or service *
Address of the school, institution, or service
Phone Number of the school, institution, or service
Email of the school, institution, or service
Do you require full supervision? *
Is there anything we need to know about the exam?  Ex. Does an affidavit need to be filed?  Does it need to be on letterhead?
REVIEW OF THE PROCTOR POLICY:  I have read and agree to Winona Public Library's Proctor Policy.   *
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