Arkansas State University-Beebe

Proctoring Form

Thank you so much for your assistance in proctoring for an ASU–Beebe student. At ASU–Beebe, we hope that your proctoring experience is a pleasant one. We would like for you to verify your eligibility as a proctor. Please read the list of responsibilities that you are agreeing to fulfill. Again, thank you in advance for your cooperation. If you have any questions, please feel free to contact the Distance Learning Office.

Deadline for submitting forms online: Spring 2010 and T4 Final Exam Testing Monday, April 26

Printable version of the Proctoring Form.

Student Information

First Name:

Last Name:

Student ID:

Course:

Instructor:

Proctor Information

First Name:

Last Name:

Address:

City:

State/Province:

Postal Code:

Country:

Phone:

Work Email:

Employer:

Proctor Status: I am faculty, administrative staff, or student services staff of an institution of higher education.
I am K−12 administration or counseling staff.
I am a duly assigned official in a military educational office.
I am law enforcement administration (Criminology students only).
Other (must be approved by the course instructor)
Other Status:

Proctoring Agreement:

By clicking "Submit" below, you confirm you have reviewed the Proctoring Guidelines and Protocols, agree that the procotor eligibility requirments below apply and that you will fulfill the responsibilities listed below:

Requirments of the Proctor
1. I am not related to the student
2. I have access to appropriate technology (fax, mail, email, etc.)
3. I understand that I will receive no compensation for proctoring services from neither the University nor the student and the student is responsible for any institutional proctoring fees.
Responsibilities of the Proctor
1. Receiving and maintaining security of course materials
2. Verifying student identification by checking official picture identification.
3. Following instructior instructions for test delivery
4. Returning the exam to the Instructor as soon as is possible

Arkansas State University-Beebe with campuses at Beebe, Heber Springs, Little Rock Air Force Base, and Searcy

Proctoring Form

Distance Learning