Student Name: *

Phone Number: *

Evening Phone (if different):

KCTCS Email:*

Name of the course for which an exam must be proctored: *

Class Catalog Number:*   (Ex. 101Eng)

Section Number: (example: 22Z1)  

Name of your Instructor * :

Your Instructors College* :

Preferred Testing Location: Downtown Campus Southwest Campus Carrollton Campus Shelby County Campus Jefferson Technical Campus

Preferred Test Date (Example: December 3, 2007):*       Testing center closed Friday, Saturday, and Sunday

Preferred test start time: (between 9:00 am and 2:30 pm) Proctor Center closes at 3:00 PM.

What items are you allowed to have with you while testing (subject to verification with instructor):

Student should be prepared to present a picture ID. Contact Robert Johnson or call 502-526-1600 if you have questions or require special arrangements.

All students must have a scheduled appointment. Typically, we are not able to accommodate walk-ins. Once your reservation request has been confirmed, you are responsible for keeping this appointment time. If you are unable to make your appointment, please contact your scheduled campus proctor or the JCTC eLearning HelpDesk at 502.213.7100 or by eMail to jf-elearning@kctcs.edu. This includes if you:

1. will be late
2. need to reschedule
3. have dropped the course in question