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SLCC~ Exam Information Directions: form is to be (South Louisiana Community College)

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SLCC~
SOUTH LOUISIANA COMMUNITY COLLEGE
PROCTORING SERVICES REQUEST FORM
Directions: form is to be completed by the instructor and emailed to testing@solacc.edu. The email must be sent
from their school email account. All other email accounts will be considered invalid and not accepted. Appointments
must be made two weeks prior to test date. Exam fee is $33.50 for each 90 minute session. Student will need to
bring photo ID and your email receipt from Register Blast on the day of testing. Once we received this form we will
call the student to complete the registration process and have them pay online via Register Blast. All proctored
exams are administered at 9:00 AM every Monday, Tuesday, and Thursday.
Exam Information
Course Name: ________________________________________________________________________
Exam Name: __________________________________________________________________________
Exam Type: ☐ Computer/Internet Exam ☐ Paper Exam
If Computer Exam, URL: ________________________________________________________________
Time limit: ___________________________________________________________________________
Allowable Equipment: __________________________________________________________________
Special Instructions: ____________________________________________________________________
Requested Date/Deadline for Proctored Exam: _______________________________________________
Student Information
First Name: ___________________________________________________________________________
Last Name: ___________________________________________________________________________
Email: ______________________________________________ Phone: __________________________
Instructors Information
First Name: ___________________________________________________________________________
Last Name: ___________________________________________________________________________
Email: ______________________________________________ Phone: __________________________
Campus Address: ______________________________________________________________________
*Email login and password for any online exams and any copies of physical exams to testing@solacc.edu
along with this form.
For Office Use Only
Form Received On: ___________________ Exam Received On: _____________________________
Exam Take: _________________________ Proctor Name: _________________________________
Comments: ___________________________________________________________________________
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SLCC Exam Information Directions: form is to be (South Louisiana Community College)

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Completed 26 July 2020

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