Proctor Request Form - Testing Center - Central Virginia Community College

Proctor Request

Students who wish to take any test at a site other than the main campus of Central Virginia Community College (Lynchburg, VA) must complete a Proctor Request Form and submit it to the Testing Center at CVCC. The proctor must be a staff member at a testing center at a college or university. Proctors cannot be a family member.

The Testing Center must approve all proctors and reserves the right to reject requests or proctors for any reason. If approved, exams will be sent to the proctor. If denied, the Center will contact the student. If the proctor charges a fee or postage to return the test, payment is the student's responsibility.

Download Microsoft Word or Acrobat Reader version of this form.

Request Form (Complete 1 form for each class)
Student Information
Full Name	EmplID

Email	Daytime Phone	Nighttime Phone

Address

City	State	Zip

Checking this box and submitting this form, constitutes your written signature.

Course Information
Course	Section	Instructor	Semester

Reason for Request

Proctor Information
Full Name	Title

Place of Employment	Department

Email	Office Phone	FAX Number

Address

City	State	Zip

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Class Schedule

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FOR MORE INFORMATION:

Click one of the following links:

Contact the Testing Center:

Testing Center
Central VA Community College
3506 Wards Road
Lynchburg VA 24502

Telephone: 434.832.7827

Located in Bedford Hall, Room 3205

Summer Testing Hours:


Mon-Thurs	9am - 9pm
Fri	9am - 12pm
Sat-Sun	CLOSED