Student Proctor Form | Maryland Applied Graduate Engineering

PLEASE NOTE: Your suggested proctor will be sent a request to complete their portion of the proctoring agreement immediately upon submitting this form, so please make sure they’ve been notified and have agreed to be your proctor for the semester.

First Name *

Last Name *

UID Number *

Course(s) *

ex. ENPM XXX, refer to email(s) if unsure.

Semester *

Fall 2023

Winter 2024

Spring 2024

Summer 2024

Email Address *

Proctor's First Name *

Proctor's Last Name *

Proctor's Email Address *

Proctor's Phone Number *

Relationship to Proctor *

Enter Your Signature *

By submitting my electronic signature above, I certify that I have read and understood the above statements, will abide by the MAGE and University proctoring and academic policies, and am responsible if the proctor does not adhere to the regulations as stated herein.

Today's Date *

Month

Day

Year

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

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