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Staff Program Room Request
Program Title
*
Include even if soft hold
Date(s) of Program
*
Room Requested
*
Tyler Hedges Room
Large Meeting Room
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Study Room A
Study Room B
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Terrace
Program Status
*
Firm hold
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Soft holds expire 2 weeks before date if not confirmed
Set Up Time
*
:
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*
:
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AM/PM
End Time
*
:
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AM/PM
Includes cleanup & room breakdown
Staff Contact
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Email
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Phone Extension (if applicable)
Presenter (if applicable)
Presenter Email Address
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Questions, Comments or Special Instructions
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Name
*
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*
Phone
*
Position
*
Letter of Interest & Resume
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Student Name
*
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*
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Type of Exam
*
Learning Institution
*
What format is the exam?
*
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Proctoring Requirements
Please note whether your learning institution has special requirements for proctors such as proctor registration.
Requested Date & Time
*
Please be aware that there is no proctoring on weekends. All exams are dependent on the availability of the proctor.
Notes or Comments
Fees
*
I acknowledge that as of August 1, 2018, proctored exams are subject to a $10 fee. Additionally, I understand that I am responsible for any costs (printing/faxing) associated with my exam.
Scheduling
*
The proctor will set aside time specifically for you and may not be able to make adjustments should any requirements not be followed.
I acknowledge that failure to comply with any requirements may delay the ability to take the exam.
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