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.
Name *
(First & Last)
Your answer
Phone Number *
Your answer
Email
(Optional)
Your answer
Name of Exam *
What exam are you taking?
Your answer
When is the exam due?
Your answer
How long is the exam?
Is there a time limit? If so, what is it?
Your answer
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?
Your answer
What time would you like to take the exam?
Time
:
Is the exam online or on paper? *
Name of the school, institution, or service *
Your answer
Address of the school, institution, or service
Your answer
Phone Number of the school, institution, or service
Your answer
Email of the school, institution, or service
Your answer
Do you require full supervision? *
Is there anything we need to know about the exam?
Your answer
REVIEW OF THE PROCTOR POLICY: I have read and agree to Winona Public Library's Proctor Policy. *
Submit
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