Distance Learning Online
Registration Request

Please fill out all sections of this form, unless otherwise noted. Once submitted, someone from the testing center will contact you.

Your Name:
Contact Phone Number:
Contact Email:
Date(s) you would prefer to take the test:
Number of exams to be proctored:
Amount of time given for each exam:
School, Institution or Agency the test is for:
Submit any additional information required or questions for the Center (optional):
I am aware of the testing fees for each exam.  

This form is to be used to request proctoring service for Distance Learning exams and/or other agencies

By submitting this form you are making a request and does obligate the center to proctor your exam.  
We will respond, via email, within 72 business hours.

To register for CLEP or MAT, please click here.