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Online Course Proctoring Request - Free Education Template | ZenBuild | ZenBuild

Templates→Education→Online Course Proctoring Request

Online Course Proctoring Request

Request form for students needing proctored exam arrangements for online courses.

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CategoryEducation

IndustryEducation

Fields13

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online courseproctoringexamdistance learning

Online Course Proctoring Request — Form Fields

This education template includes 13 fields. Request form for students needing proctored exam arrangements for online courses. Free to customize and use on ZenBuild.

Student Name (text, required)
Student Email (email, required)
Student ID (text, required)
Course Name and Number (text, required)
Instructor Name (text, required)
Exam Date (text, required)
Exam Duration (dropdown selection, required) — options: 1 Hour, 1.5 Hours, 2 Hours, 2.5 Hours, 3 Hours
Proctoring Method (dropdown selection, required) — options: In-Person Testing Center, Live Online Proctor, AI-Monitored, Lockdown Browser Only
Testing Center Location (dropdown selection, optional) — options: Campus Testing Center, Community College Partner, Library, Approved Remote
Accommodations Needed (checkboxes, optional) — options: Extended Time, Reader, Scribe, Separate Room, Frequent Breaks, Assistive Technology
Calculator Allowed (multiple choice, optional) — options: Yes, No
Notes or Reference Sheet Allowed (multiple choice, optional) — options: Yes, No
Special Instructions from Instructor (long text, optional)