Correspondence Examinee Request Form  

    By filling out and submitting this form you are stating that you would like to take a proctored exam at Coastal Bend College and are aware of the Correspondence Exam Fee of $25.00 per exam.   

    Enter your full name: 


    Enter your phone number: 


    Enter your e-mail address: 


    Enter the name of your home institution: 


    Enter the name of the course (Ex:  College Algebra – Math 1314.012) 


    Enter the name of your instructor: 


    Enter the number of exams that you will need to have proctored:    

    Enter the approximate date/(s) of when the exam/(s) should be sent: 


    Type of exam:   




    Approximate time allowed for exam (Ex:  1 hour/ 2 hours/ etc....)    

    Select which of Coastal Bend College’s locations you would like to take your proctored exam:   




    You are responsible for contacting your home institution and providing them with the appropriate contact information for the test center that you would like to use. 

    Your home institution must fill out and submit the  CBC Exam Check Sheet  which will be  e-mailed to the appropriate CBC site. 




    Proctor/(s) Name/(s)  

    Phone Number  

    E-mail Address  





    Alice Site  - Room 130     

    Francin Herrera or J. R. Cavazos          

    (361) 664-2981 Ext:  3045     






     Beeville Site  - Room V-131 

    Sandra Mendez or Rachel Malone      

    (361) 354-2334 






    Kingsville Site  - Room 135 

     Anthony Jimenez  

    (361) 592-1615 Ext:  4070 






    Pleasanton Site - Check in at Front Desk Area            

     Peggy Meyer 

    (830) 569-4222 Ext: 1201 


    Testing Coordinator - Roberta Kreis - located on the Beeville site

    Testing Contacts List – for physical addresses 

    After you’ve sent your institution the contact information for the testing center you will use, Use our on-line scheduling site - click here to make your appointments.  Make your reservation as soon as the instructor tells you when the exam needs to be administered - so that you can guarantee your appointment.  Don't wait to schedule.   We have limited seating and you’ll want to guarantee a spot as soon as you can.

    On your scheduled test date, please pay the Business Office /CBC Site Front Desk area/ or Beeville Testing Department the $25.00 Correspondence Exam Fee.  You will need to take a copy of the receipt and your Photo ID to the Testing Center.

    All personal items will need to be left in a designated area away from the exam area.  If you bring a cell phone – it will need to be completely turned off and left in the designated area.  Only items that your instructor specifies will be allowed at your exam area.

    If you have a proctor agreement form that needs to be signed by the Coastal Bend College Testing Center - please e-mail it to testing@coastalbend.edu. 




    Form created - 9/4/15
    Revised 4/18/18