UWG Online Student Exam Notification Form

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IMPORTANT - Please review the Proctored Exam INSTRUCTIONS for Online Students at http://uwgonline.westga.edu/exams.php#student.

IMPORTANT - Before you fill out this form, make sure you have actually contacted a testing site and made an appointment or you have logged onto ProctorU and scheduled an appointment.

Email *

Student Details

Student First Name: *

Student Last Name: *

Preferred Email Address: *

(for receiving important updates)

Campus Email Address: *

Student ID (full 917#): *

Student Phone Number: *

Instructor Details

Instructor's Name *

Instructor's Email Address *

Testing Center Details (if using ProctorU, type "ProctorU")

Testing Official First Name: (if using ProctorU, type "ProctorU") *

Testing Official Last Name: (if using ProctorU, type "ProctorU") *

Testing Official Phone Number: (if using ProctorU, type "ProctorU") *

Testing Official Email Address: (if using ProctorU, type "ProctorU")

Name of Testing Site: (if using ProctorU, type "ProctorU") *

Full Address of Testing Site: (if using ProctorU, type "ProctorU") *

Exam Details

Agreement of Understanding *

REQUIRED: Students MUST contact the testing center or ProctorU and schedule their appointment directly with the testing site (but within the time-frame allowed by your instructor). I hereby agree that I have read this statement, followed these instructions, and that the "Scheduled Exam Date" and "Scheduled Exam Time" listed below has been confirmed with the testing site coordinator or in my ProctorU registration receipt. I understand it is my responsibility to consult with the testing center of my choice or ProctorU, in order to verify cost, payment options, and any other requirements for testing. I acknowledge that failure to follow these procedures may result in a failed exam.

I agree

Required

Course Prefix: *

Course Number: *

(1101, 1212, etc.)

Scheduled Examination Date: *

YYYY

Scheduled Examination Time: *

(Some browsers may use a 24 hour clock without AM/PM below. See http://www.onlineconversion.com/date_12-24_hour.htm for conversion help.)

Time

Scheduled Examination Time Zone: *

(Eastern, Central, etc.)

Submit

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