Proctor Request Form

Faculty name:
Faculty dept:
Faculty phone:
Faculty email:
Student name:
Date of exam:
Time of exam:
Length of time allowed for exam:
Exam will be: Dropped off the day of the exam at the Brown Library Reference desk.
Dropped off prior to the exam at the Brown Library Reference desk.
Sent to Brown Library Reference Department via campus mail.
Exam is: Open book.
Closed book.
Other, please describe below.
Special instructions:
After the exam: I will pick up the exam at the Brown Library Reference Desk
Please return the exam via campus mail.