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PROCTOR APPLICATION FORM

FORM TO BE SUBMITTED BY STUDENT OR PROCTOR

Student's Full Name: required
Student Email Address: required
Course(s):
required
  [separate additional courses by a comma, e.g. CIS110-39, NET130-25]
Instructor(s): required


SELECTION AND QUALIFICATION OF PROCTOR

  1. Students should complete this application and submit the prospective proctor information via the submit button at the end of the form.

    Criteria for recommendation are according to the following priority:
    • Local Community College Support Services Department.
    • College Professor, Administrator, or Librarian at an approved Testing Site.
    • For Military personnel, a commissioned officer whose rank is higher than the student's or the education officer on base.
    • A Principal, Counselor, or Superintendent at an approved Testing Site.

    ALL RELATIVES, CO WORKERS, & FRIENDS ARE PROHIBITED FROM SERVING AS PROCTORS

  2. Proctor candidates will be reviewed by the Department faculty/Department chair. This may involve personal interview, phone call, email, or other appropriate methods.
  3. Proctors will be notified by the Department concerning duties & responsibilities.
  4. The Instructor or Department reserves the right to reject any proctor.
  5. No Proctor fees are authorized. If a proctor charges a fee, the fee is the responsibility of the student.
  6. Once a proctor has been established and accepted, a student may not change proctors without prior notice to the Department.

*Please indicate position you hold in your profession according to #1 of this section
Proctor: required
Organization:
required
Position: required
Email Address: required


DUTIES AND RESPONSIBILITIES OF THE PROCTOR

  1. Upon receipt of exam, the proctor must keep the exam unopened and in a safe place until student is in his/her presence ready to take the exam.
  2. The student must be able to take the exam within a specified date from receipt of the exam. If he/she is not able to do this, then the proctor must return the exam to the instructor and instruct the student to contact us.
  3. When the student is ready to take the exam, the proctor will administer it.
  4. The examination needs to be taken in an appropriate and approved setting for testing.
  5. At NO time should the student be in possession of the exam without the proctor present.
  6. Upon completion of the exam, only the proctor is to return the exam immediately


The following signature attests that I, (proctor's name)
accept the duties and responsibilities of being a proctor and will comply with the proctoring policies and procedures of the Department
 
(Where testing materials should be mailed)
Location/Address
City/State/Zip
Phone Number
Fax
Email:
   
Describe Testing Site that Student would be taking exam
 
     

If you have questions or having problems submitting this form, please contact Erin Reed or Virginia Williams.


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