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Proctor Request Form

Please complete the form below if you are interested in becoming a proctor for your district. If additional individuals need to be added as proctors, please complete another form for each person. 

Required fields marked with an asterisk *

ESC Region #*
Please enter the region your district falls under.
Answer Required

Contact Information

Proctor Login Credentials

Please create a username and password to gain access to Proctor Login.  These fields are case-sensitive so you may use upper and/or lowercase letters.  You may also use numbers if you'd like.  Do not use special characters (i.e. $, !, ?, etc.)

Physical Office Address

Thank you for your interest in becoming a proctor for your district!  We will e-mail you within 24-48 hours with proctor login credentials and training information.

Confirmation Email
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