Rio Salado College

CBE Proctored Test Request Form

Please complete the following information:
Items marked with an asterisk (*) are required, the request may not be processed or could be significantly delayed if this information is not included.

Student Information

Student ID*

(Numeric keys only)
E-mail Address*

(All communication will be conducted through official Maricopa email addresses only)
Are you registered with Disability Services?*
Yes   No

Proctor Information

Proctor Name:*
Proctor Title:*
Phone Number*
Email Address*

Credit by Exam

Course Number:
Department Permission Received*
Yes   No
Are you requesting a Law Enforcement Technology exam?
Yes   No
I have read the proctoring guidelines*