: Polytechnic Institute OF NYU : ePoly Proctring Request

Proctoring Request Form

Term
Professor Name
Course ID	No Space between characters. e.g. CS5403
Students Names(Separate by comas)
Prefered Date of Exam	MM/DD/YYYY
Prefered Time of Exam	HH:MM am/pm
Book a Room	Check if Room required
Proctore Required	Check if Proctor requried
Location	Give Following detail of Facilities other then University Campus
Facilities Address
Contact Person at Facilities
Facilities Telephone
Contact Email
As a reminder, proctoring requests in Long Island and Westchester campuses should be kept during business hours or when classes are in session. Please return this request to Crystal Chavis at 718-260-3571 fax or via email at eproctor@poly.edu. Thank You

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