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Test Proctor Form

 

Proctor Instruction Sheet

A proctor should meet the following criteria:

  1. Must not be related (in any way) to the test taker.
  2. Must not be a supervisor at work.
  3. Must not be someone enrolled in the course

Suggestions:

  1. A local librarian
  2. A local school administrator
  3. A local clergy member
  4. The testing center at a local college

If you have questions concerning your proctor, contact your instructor for final determination of acceptability.

Note: Proctors have the option of charging for their services. Please discuss this with them when enlisting them as a proctor.

After you have selected a proctor, copy and print or otherwise obtain these instructions and the PROCTOR FORM below by copying and printing or otherwise, fill in the student information, and give the instructions and form to the proctor, within a minimum of three weeks of the time-interval of the test, with an addressed stamped envelope addressed to

Cliff Layton
Dept. of Applied
Technology
Rogers State University

1701 W.
Will Rogers Blvd.
Claremore , OK 74017

 The proctor should fill out the proctor information and paper mail to the instructor as soon as possible, and at a minimum two weeks prior to the time-interval of the test.

 

Proctor Form For RSU Online Class

Student Information:

 

 

 

Studentís Name:          

 

 

 

Studentís Address:      

 

 

 

 

 

Studentís Home Phone:            

 

 

 

Studentís Business Phone:           

 

 

 

 

 

Proctor Information:

 

 

 

Proctorís Name:          

 

 

 

Proctorís Affiliation:     

 

 

 

Proctorís Address:      

 

 

 

 

 

Proctorís Phone:          

 

 

 

Proctorís Fax: 

 

 

 

Proctorís E-Mail Address:

 

I acknowledge that I will be proctoring tests for

 ______________________________________
(Studentís Name)

Name of RSU Online Course  ________________________________________

THE NEXT SECTION IS FOR PROCTOR ONLY

I have read the proctor criteria and certify that I meet the requirements. I will follow all instructions that come to me with the tests and will return the test postmarked no later than the date listed.

  ______________________               _________________

Proctorís signature                                Date

Please return this page to:

Cliff Layton
Dept. of Applied
Technology
Rogers State University

1701 W.
Will Rogers Blvd.
Claremore, OK 74017             FAX:  918-343-7623    Phone:  918-343-7665

Layton@rsu.edu