Proctor Request Form
Copy the information below and paste it in the body of an email to your professor. Once it is in the email, type in the appropriate information.

This testing option is for students living more than 50 miles from Texarkana College.

Student’s Name and T#:

Address:

City, State, Zip:

E-mail:

Phone:

Class & Section # for which you are requesting a test:

Which tests are you requesting to be proctored?

Please fill out the following information regarding the proctor who has agreed to  administer/proctor the test for you. It must be someone that meets the proctor requirements listed on the Distance Education @TC link and/or your professors syllabus.

Proctor’s Name:

Institution:

Mailing Address:

City, State, Zip:

Phone:

Email:

Fax:

E-mail- work email required (.edu, .gov, etc):

Test administration instructions will be emailed to the proctor.