Examinations, Scheduling & Bookings

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email: Examinations, Scheduling & Bookings
phone: 519.884.0710 x 6098

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FINAL EXAMINATION - PROCTOR CONFIRMATION FORM

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

WILFRID LAURIER UNIVERSITY - OFFICE OF THE REGISTRAR, 75 University Avenue West, Waterloo, Ontario N2L 3C5
519-884-0710 ext. 6098/6370/6359 FAX Number: 519-884-8826
Jessica Bell at Ext. 6098 jebell@wlu.ca or Anne Snyder at Ext. 6370 asnyder@wlu.ca

Important: Please note if you need Accessible Learning Accommodations please contact our office at least 3 weeks before the start of the examination period, in order for us to arrange extra time for you

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

Due dates for On Line Learning Proctor Form and Changing exam locations for final examinations:
Winter - March 2, 2013, Intersession - May 17, 2013, Spring - June 8, 2013, Summer - July 12, 2013

IMPORTANT: Acceptable proctors are Faculty of a University or College, Principal of a Secondary or Primary School, and University Examination officers. PROCTORS MUST SUBMIT A LETTER FROM THEIR DEPT. CHAIR, DEAN OR PRINCIPAL AS PROOF OF EMPLOYMENT IN ORDER TO INVIGILATE EXAMINATIONS FOR OUR STUDENTS. As a proctor you are required to follow the rules and regulations set for the writing of examinations by Wilfrid Laurier University. The Examination must be invigilated on University, College, or school propertyand a proctor must not be related to the student in any way and must not reside at the same address.
STUDENTS WRITING OVERSEAS ARE REQUIRED TO WRITE WITH AN ACCREDITED UNIVERSITY WHICH MUST BE APPROVED BY WILFRID LAURIER UNIVERSITY EXAMINATION OFFICE. DOCUMENTATION FROM THE OVERSEAS INSTITUTION IS MANDATORY.
This form must be returned to us by: see above. Failure to send the proper information by the due date may mean that an examination will not be available for you to give to the student. Please see further proctoring information, Guidelines for OC Students. The examination will be sent to you approximately 10 days before the examination is to be written.

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? : ________________

I agree to follow the rules and regulations set for the writing of examinations.

I certify that I am a suitable proctor for this student.

DATE : _________ PROCTOR SIGNATURE : ______________________ STUDENT SIGNATURE: ___________________

**ANY PROCTORING FEES CHARGED ARE THE STUDENT'S RESPONSIBILITY**