Worldwide Learning Proctor Approval Form

Please complete the form below to submit your proctor for approval. Once you have an approved Worldwide Learning proctor, that proctor may be used for all your Worldwide Learning courses. All proctors are subject to approval.

NOTE: Be sure to speak with your proctor BEFORE submitting this form. Proctors will be contacted to verify their information before they are approved.

Student Information
Student's Last Name:
Student's First Name:
Student ID Number:

 
Proctor Information
Exams, quizzes, and other materials will be sent directly to the addresses provided below. A business address, phone number, and e-mail address are required. Please double-check this information to avoid errors. Students are responsible for filing accurate information to ensure proctors receive the materials and information they need.
Proctor's Last Name:
Proctor's First Name:
Proctor's Business Mailing Address:
   City:
   State/Province:
   Zip/Postal Code:
   Country:
Proctor's Business/Daytime Phone
(e.g. 701-555-5555):
Proctor's Business Email Address:
Verify Email Address from above:

Proctor Criteria

In order to be approved as a proctor, a proctor must be a disinterested professional with a valid business and email address. Some examples that meet the criteria are listed below.

A proctor must NOT be:

  • A friend or relative of the student
  • Someone enrolled in the course
  • Someone living at the same address as the student
Which of the following best describes your proctor? (choose one)

   A superintendent, principal, or counselor at a public school
   An elementary or high school teacher
   A college or university administrator, dean, department chair, registrar, or faculty member
   A professional staff member at a college or university
   A certified librarian
   A civil service examiner
   A judge of a court of law
   A human resource director or employee development coordinator
   A military officer or non-commissioned officer of a higher rank
   A law enforcement officer
  Other, please indicate:

Proctor's Title/Profession:
Proctor's Employer:
   Employer's Website:

Enter your full name below to certify that all statements in this application are complete and true,
and that you understand that violation of these terms will significantly affect your grade and your ability to take Mayville State Worldwide Learning courses. :
By submitting this application, you are certifying that all statements in this application are complete and true.