EmailMe Form - JCTC Proctor Reservation Form

Student Information

Name *

First Last

Phone *

### - ### - ####

KCTCS email address *

Are you a current KCTCS student? *

Yes

No

Exam Information

What is your course subject and number? (example: ENG 101) *

What is your class section number? (4 digits; example: 55Z1) *

What is your instructor's name? *

Choose a testing location *

Choose a test date *

MM / DD / YYYY

Proctoring services are available Monday - Thursday. Requests must be made at least 2 working days in advance.

Choose a time *

HH : MM AM/PM

Select a start time between 9:00 AM and 5:00 PM. Each appointment is scheduled for a two hour block. Available times may vary by campus. Please note that later times may be restricted to specific campuses and/or days of the week. After selecting your preference, your proctor can better inform you of your options.

Campus Information:
Southwest: Open 10:00am - 4:00pm
Downtown: Closed 11:30am - 12:30pm
Technical: Closed 12:00pm - 1:00pm

Special accommodations? Submit document here.

Additional comments

Proctor Reservation Agreement

I have completed/understand the following:
(you must check each box) *

Provided a college email address

Selected a date at least 2 days (M-F) in the future

A proctor will contact me by email

Non-KCTCS students may be charged a fee

Non-KCTCS students are limited to 2 exams per semester