Arizona Department of Real Estate (ADRE)
Professional Education Division
www.azre.gov
100 N. 15
th
AVENUE STE-201, PHOENIX, AZ 85007
DOUGLAS A. DUCEY
GOVERNOR
JUDY LOWE
COMMISSIONER
FORM ED-200-OPE 3-13-2020
ONLINE PRE LICENSE SCHOOL EXAMINATION PROCTOR CERTIFICATION
(FORM ED-200-OPE)
INSTRUCTIONS
Schools should complete this form for each student who has completed the requisite course work for an online
pre licensing course, and provide it to the proctor with the online examination.
After the examination is administered, the proctor should complete the remainder of the form and return it to the
school. The school must immediately send ADRE a copy of the completed form upon its completion by the
proctor through the Message Center at www.azre.gov.
SCHOOL INFORMATION:
School Name
School Administrator
School License Number
ONLINE COURSE INFORMATION:
Course Name
ADRE Course Number
STUDENT INFORMATION:
Name of Student
PROCTOR INFORMATION:
Name of Proctor
Email Address
Name and Address of Third Party Proctor Facility
City
State
Zip Code
Telephone No.
PROCTOR CERTIFICATION
I certify that:
1. I am a disinterested third party in the administration of this examination. I am not related by blood, marriage, or any
relationship to the above-named student.
2. I have no financial or business interest in the outcome of this examination.
3. The student showed me positive photo identification prior to completing the examination.
4. The examination was administered in my presence and under my supervision on
5. The student received no assistance and had no access to books, notes, electronic media or reference material and
accessed and completed the examination on a computer with a locked down browser.
6. I have not permitted the examination to be compromised, copied, or recorded in any way or by any method.
________________________
Date Signature of Proctor
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signature
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