Proctor Agreement Form |
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Student Agreement
As a student, I agree to the following:
- I will be responsible for locating a proctor (exam supervisor) and scheduling appointments for tests.
- I will be responsible for all proctor fees, if any, and mailing expenses.
- I will take the tests by the due dates assigned by the instructor.
- I will notify the SinclairOnline Testing Coordinator if I add or drop courses.
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Date:
*Term:
*Year:
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| *Student Name:
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| *Student Email:
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| *Tartan ID or Last 4 Digits of Social Security Number:
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| *Address:
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| *City:
*State:
*Zip Code:
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| *Daytime Phone Number:
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| I would like a Placement Test:
Yes
No |
| I would like a Proficiency Test:
Yes
No |
Course(s) Requested:
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Proctor Agreement
Proctors must agree to the following:
- Their professional position is one the following: education official, librarian, or teacher at a community college, university, elementary or secondary school; an education director at a hospital; a staff director, human services training director, test administrator, or educational services officer or any commissioned officer of higher rank than the student (military).
- They are not a current Sinclair Community College student.
- They are not a relative of the student, personal friend of the student, direct supervisor of the student, employed by the student, co-worker of the student, live at the same address as the student, nor does their position/relationship with the student present any conflict of interests.
- They will personally administer and supervise the indicated test, providing the student access to the test only while the student is testing.
- They will personally mail the completed test(s) back to Sinclair Community College by the specified due dates.
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| *Proctor Name:
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| *Institution/Work:
*Official Title:
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| *Institution/Work Address:
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| *City:
*State:
*Zip Code:
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| *Institution/Work Phone Number:
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| *Institution/Work E-Mail:
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Test Mailing Address (If different than above Institution/Work address only) -
Tests will not be sent to a private residence):
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| *Proctor Highest Academic Degree:
*Proctor Major:
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Special Instructions:
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| *Relationship to student:
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