PROCTOR FORM 

Tests cannot be sent directly to the person writing the test. They can only be sent to a proctor. Please have the person who will be proctoring (supervising) your test, complete the Proctor Form and mail or fax it with your order form.

Proctors should be one of the following:


Peace Officer

Doctor

Nurse


Court Official 

Lawyer

Teacher


Religious Official

Fireman

Engineer


• Proctors must be of adult age (age of majority of each province) and cannot be related to the person 
  writing the test.

• A Proctor must ensure that when the person is writing the test that no books or materials related to boating 

  are present and that you, the proctor, are present at all times to supervise the individual.

• You are also responsible for returning the tests to respective Agent.

• Please complete the form below and mail or fax to respective Agent.

PLEASE PRINT

Last Name __________________________________________________
First Name _________________
Street Address  __________________________________________________________________________
City  _________________________ Prov. ________________________ Postal Code ________________
Date of Birth  ________________________________________________
  Day Month Year
Home Phone Number (_____)  __________________________________
Business Phone Number (_____) ________________________________
Occupation __________________________________________________

Signature ____________________________________________________


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