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Proctor Expense Report
Facility Name: *
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Proctor's First Name: *
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Proctor's Last Name: *
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Exam Date: *
MM
/
DD
/
YYYY
Proctor Expense Calculation
Duration of Exam (2.5 hours max): *
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Pre & Post Exam Coordination (.5 hour max): *
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Total Hours: *
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Hourly Fee: *
Dollar ($) value
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Total: *
Dollar ($) value
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Proctor Payment Information
Payable to: *
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Address 1: *
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Address 2:
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City: *
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Province: *
Postal Code: *
Please use format A9A 9A9
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Credit Union Institute of Canada
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