Site Accessibility Statement
Wilfrid Laurier University Office of the Registrar
September 19, 2014
 
 
Canadian Excellence

FINAL EXAMINATION - PROCTOR CONFIRMATION FORM


Please print and have the proctor fill out this form with all pertinent details.

Click for printable version.

 IMPORTANT: Students are not allowed to change the exam dates and times.


Accessible Learning Accommodations: Please contact our office at least 3 weeks before the start of the examination period, in order for us to make arrangements. 

 

Please note: Each student must find their own proctor. Multiple students cannot use the same proctor.

 


Deadline dates for Online Learning (OC) Proctor Form and Changing exam locations for final examinations:

Fall 2014 Proctor Deadline date: OCTOBER 29, 2014

**PLEASE NOTE, THESE DEADLINE DATES ARE FIXED, LATE PROCTOR FORMS WILL NOT BE ACCEPTED**

 

Student Name : ______________________________ ID Number : _____________________________
COURSE
DATE
TIME
1.    
2.    
PROCTOR INFORMATION
NAME:_______________________________ PHONE NUMBER:_____________________

ADDRESS:

Street :_________________________ Apt.# : ____________ Country : _____________________
City : __________________________ Prov. : ____________ Postal Code : __________________
E-MAIL ADDRESS : __________________________________________
COURIER ADDRESS ( for delivery of the examination to the proctor )
Street :_________________________ Apt.# : ____________ Phone # : _____________________
City : __________________________ Prov. : ____________ Postal Code : __________________
Occupation : ____________________________ Are you retired : ________________
Place of Employment : ____________________________________________________ (Last place if retired)
EMPLOYER ADDRESS :
Street : ____________________________________________Suite # :
City : __________________________ Prov. : ____________ Postal Code : __________________
Telephone Number of Employer : ____________________________
Have you proctored before? ____________ If yes, for what institution : ____________________________
Are you interested in proctoring for other students? : ________________

STUDENT PLEASE READ:
I confirm that I have read and agree to follow the Examination Regulations and Code of Conduct set for the writing of examinations.

DATE : _________ PROCTOR SIGNATURE : ______________________ STUDENT SIGNATURE: ___________________
**ANY PROCTORING FEES CHARGED ARE THE STUDENT'S RESPONSIBILITY**