Internal Trainer Request for Exam Codes and/or Request to ProctorIf you are an External KCS v6 Trainer, please request exam codes or proctor setup here.Name:(Required) First Last Email:(Required) What do you need help with?(Required)Please choose one.Receive coupon codes for team members taking the exam on their ownSet up an exam to proctor in personEmail Address to use as a Proctor in Webassessor:(Required)This can not be the same as the address you used as a test taker in Webassessor. Phone you can be reached at while proctoring:(Required)Exam you are requesting to proctor:(Required)Applicable discounts apply to KCS Practices Exam and Practice Test (see below). Trainer exam will be invoiced at list price. Choose one:KCS v6 Practices ($450 list price, Retake Exam – $170)KCS v6 Trainer ($650 list price)Include the practice test? ($85 list price less applicable discount below)(Required) Yes NoDate the exam will be administered:(Required) MM slash DD slash YYYY Maximum number of students taking the exam:(Required)Name of exam location:(Required)Address of the exam location:(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Approximate time the exam will be started:(Required)Exam location time zone:(Required)Percent Discount your company receivesAll companies who have purchased the corporate license for training, receive a 10% discount off the price of exams. Consortium Membership provide additionally discounting as outlined below regardless of exam delivery method 10% Consortium Non-member 10% + 10% Participant Level Membership 10% + 15% Participant Plus Level Membership 10% + 20% Sponsor Level Memberhsip 10% + 25% Benefactor Level MembershipNotes:Any additional things you would like us to know? By submitting this form, you agree:you are responsible for distributing exam codes to test takers, andto be invoiced at list price less the applicable discount.Exam you are requesting codes for:(Required)Choose one:KCS Practices ($450 list price, Retake $170)KCS Trainer ($650 list price)Include the practice test? ($85 list price less applicable discounts below))(Required) Yes NoApproximate date of associated workshop:(Required) MM slash DD slash YYYY Last day to register for the exam:(Required)Please enter the date that a student must register for the exam by. Best practice: last day of the month of the workshop or 30 days from workshop. MM slash DD slash YYYY Last day the exam can be taken:(Required)Please enter the date a student must complete the exam by. Best practice: within 60 days of workshop. MM slash DD slash YYYY Approximate number of coupon codes needed:(Required)You will only be charged for coupon codes used.Percent Discount your company receives(Required)All companies who have purchased the corporate license for training, receive a 10% discount off the price of exams. Consortium Membership provide additionally discounting as outlined below regardless of exam delivery method 10% Consortium Non-member 10% + 10% Participant Level Member 10% + 15% Participant Plus Level Member 10% + 20% Sponsor Level Member 10% + 25% Benefactor Level MemberNotes:Any additional things you would like us to know? By submitting this form, you agree:you are responsible for distributing exam codes to the test takers,to communicate the Kryterion reschedule/cancellation policy to the test takers, andto be invoiced at list price less the applicable discount.PhoneThis field is for validation purposes and should be left unchanged.Δ