Online Exam Request Form

Student First Name:
Student Last Name:
EOU Student ID Number:
Your EOU Student ID Number is NOT your Social Security Number and should
begin with a 910- prefix.
You can check on Webster for your Student ID Number.
Current EOU E-mail:
Current Telephone:
**Proctor First Name:
**Proctor Last Name:
Proctor Place of Employment:
Proctor E-mail Address:
Proctor Phone Number:
Course #1
Course Prefix: Course Number:
Course Name:
Course Exam:
Term You Registered:
Testing Services - One University Blvd., La Grande, OR 97850
1-800-544-2195 - e-mail: