Proctor Verification

Proctor Verification Form

Student Information

Student's Name:*

Student's Date of Birth*

Student's Parent/Guardian's Email Address*

If applicable, does the student have permission from their counselor to take the final exam with you?*

Yes No N/A (Home School Student)

If no, the student will need to find out from their counselor if this is allowed.

Courses Being Proctored

Course*

At least one course should be named.

Course

Date the Exam(s) will be Proctored:*

If the student is taking exams on multiple dates put in the earliest date.

Proctor Information

Proctor's SC Educator Licensure Number**

*To locate this number, please check the physical print out of your Educator Certification. Follow our Step-by-Step Tutorial for how to find your Licensure Number by clicking the link below.

How to Find Your Licensure Number

Proctor's Full Name:*

Proctor's Date of Birth (mm-dd-yyyy)*

Proctor's E-Mail:*

Confirm Proctor's E-Mail: *

Proctor's Phone Number:*

Please list the proctor's educational role:*

Teacher School Counselor Administrator

Is the proctor related to the student listed above? *

Yes No