Southside Virginia Community College Libraries
Request for Test Proctoring, Alberta

Instructions: Extended Learning Centers and Distance Education Faculty may use this form to submit a test proctoring request to the Julian M. Howell Library, located at 109 Campus Drive, Alberta, Virginia (434-949-1065) . Carefully fill out the form and press the submit button. Processing the request takes 1 - 3 business days and an e-mail confirmation will be sent.

Please fill out the form completely and press the submit button when done; reset clears the form

Name of Institution:        

Course Information:        Subject:    Number:    Section:

Current Semester:    Fall    Spring    Summer

Instructor's Name:         Instructor's Email:   

Instructor's Phone:   

Instructor's Address:   

Date to be Taken:   

Time to be Taken: 

Date to be Picked Up or Mailed:   

Time Allotted:    Hours:     Minutes:     No time limit:

Student's Name: 

Student may refer to:    Notes    Book    Calculator    Fact Sheet/Formula    Other (please specify)

Testing Restrictions:

Comments:   

*Students or Instructors will need to provide Scantron forms if needed!
By pressing "submit", you are verifying that all of the information provided is correct and complete!