Southwestern
Adventist University

Adult Degree Program

Proctor Form


Double check spelling, addresses, and especially zip codes, before sending.   Be as complete as possible.     * required data field in order to send

  
Student Data
Name: *           ID:  
Address:
 
 
City:     State:       Zip:   
Country: (if not USA)            
E-mail:
Home Phone:   Cell Phone:   Work Phone:
 
 

Select your proctor carefully!   He or she should be a person that can meet your needs in a responsible and timely manner; that is, is someone who is likely to be available for a long term, can hold materials in a secure place, be available when you need to take a test or quiz, has quiet place for you to sit the exercise, and will mail all the required materials back in a timely manner.
First Time to Specify Proctor
Proctor Change
Address Change Only
 

Proctor Data
Name: *
Title or Position: (if applicable)    
Address: *
 
 
City: *     State:    *     Zip:   *
Country: (if not USA)            
E-mail:     Phone: *  
 
Profession of Proctor: Proctor should be a professional person - examples:   teacher, librarian, pastor, church officer, or secretary to one of these professional people.
  *    
 
Relationship of Proctor to Student:
Proctor should not be a spouse, relative, fellow student, or fiance regardless of other qualifications
  *    
 
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