Thank you for agreeing to proctor this exam. Please read the form very carefully before filling it out. If you have any questions, please call the Virtual Campus at 800-227-2013.

When the exam is completed, please sign the statement below, and return this form with the exam and answers. The student must take the exam within one week of the date you receive it; if there are extenuating circumstances that prevent this, please contact the Virtual Campus as soon as possible. Please note that under no circumstances may this exam be copied.

Student Name _____________________________

Exam Title (as it appears at the top of the exam) _________________________________________

Proctor's information:

Name: ___________________________________

Address: __________________________________

      _________________________________

      _________________________________

  I, ________________________________ (printed name of proctor), verify that the above named student: .

• began the exam at ___________ (time)
• used only pen/pencil and paper, and no notes or books (unless as stated on the exam)
• took the exam in one sitting, without interruption
• returned the exam to me at __________________ (time), and that this is within the allotted time specified on the exam.

Furthermore, I will place the exam — along with this form and any scrap paper — in the student-provided, stamped, addressed envelope, and will seal it with my signature and date across the back flap, and then mail it.

The enclosed exam was taken under my supervision and in accordance with the guidelines listed above. No copies have been made of this exam.  

Thanks again for this service to the student and to Reformed Theological Seminary.

Reformed Theological Seminary 
Virtual Campus 
2101 Carmel Road 
Charlotte, NC 28226