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Outside Proctor Request Form (Non-LCC)

General Information ( * Denotes a required field)

*Are you a student from an outside institution, not LCC, and need LCC to proctor for you?     Yes No

*Are you a current LCC student taking a class at another college for credit at LCC?     Yes No

*Please complete the following information:

Student Information

*Student Name      

*Birth Date                 

*Student Telephone     

 *Email Address            

*Verify Email Address    

Educational Institution Information

*Contact person at institution:      

*Contact person telephone:   

*Institution Name:      

*Contact Person Email Address:

*Verify Contact Person Email Address:

Do you require special testing accommodations, if so please explain. (Please note that documentation may need to be provided for your request)

Other Comments


The Testing Support Office requires one to three businesses days to process a request.

For additional information, please visit our website at

If you have any questions or concerns, please contact Mark Polzin at:
517-267-5513 or by email at


Assessment Center at Lansing Community College

Testing Services

Course Testing Center - TLC 104
Placement Testing Center - GB StarZone

Phone: (517) 267-5500
Additional contact information »

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