Proctor Information and Form

Proctor Request Form PROCTOR FORM — FINAL EXAMINATION To increase legibility please complete form online and print for signature

Student Name: Student Telephone Number: Student Email Address: Exam location: Course(s): *Please note, that the proctor, not the student, will be emailed a pass code that will unlock the student’s final exam once this proctor form has been processed. The student must contact the proctor to make arrangements to take the final exam. The final exam must be completed before the course end date.

Suggestions for a suitable proctor are (but not limited to) the following: an education official such as a counselor or teacher at a community college, university, a member of your local clergy, a librarian at your local library, a testing administrator or an educational services officer (ESO) if you are in the military. Proctor Name: Proctor Telephone Number: Fax No: Proctor Email Address: Proctor Street Address: City: State:

Important - Proctor must read the following and sign below:  I agree to provide proctoring for the above student.  I certify that I am not a student or former student of AAU, or related by blood, marriage, or any other relationship to the person, scheduled to take this examination.  I certify that I will check a photo I.D. confirming the identity of the person taking the test.  I agree to follow the Instructions for Proctoring an Exam and to faithfully assure confidentiality of materials entrusted to my care.  I verify that the above information is true and correct.

Proctor signature: ______Fax completed and signed form to 949-707-2978 OR Email to [email protected]

If you are unable to find an individual to proctor your final exam you may use Proctor U: I am utilizing ProctorU’s services (Only complete student section of the form); fax form with above portion filled out to 949-707-2978 OR Email to [email protected] *If you are utilizing ProctorU, it is your responsibility to contact Proctor U at [email protected] to schedule your final exam before your course end date. You will need to use a web cam and you will be responsible for any fees associated with this service.

Updated on 02-27-2012