Request for Proctor

College of the Mainland requires a request for proctor in order to schedule Distance Education/Other exams. Upon completion and submission of this form I will receive an email verifying my scheduled test date and time. Please allow two business days for a response.

Indicates required fields

Examinee First Name:

Examinee Last Name:

Preferred Test Date:

Preferred Test Time AM or PM:

College or Institution if Applicable:

Length of Exam:

Email Address:

Phone Number:

Date of Birth:

Exam Type:

Distance Education Other

Comments/Other:

Required for Testing:
$29 Proctor Fee
Proctor Fee does not apply to ATB or TABE
Valid/Current Picture ID
Exam Appointment with Email Verification

Examinee Signature By signing I understand that it is my responsibility to ensure I have scheduled adequate time to complete my exam. If I choose to schedule and/or take my exam in less time than allowed, I will be required to sign a waiver to test.