Piedmont Community College Proctor Application Form

If you meet the following criteria and are willing to serve as a proctor for this student, please complete this application form. Piedmont Community College thanks you for your willingness to assist this student in the examination process.

Principal or Superintendent of Educational Service Region, School, or District,
Dean, Academic Department Head, Extension Administrator, Counselor, Librarian, Testing Service of an Accredited University/College,
High School or University/College Instructor, and
a proctor may not be a friend, relative, or current PCC student.

The responsibilities of a proctor are outlined below. We ask that all proctors adhere to these guidelines whenever administering an exam or assignment:

The student is responsible for making initial contact with the proctor to make the necessary arrangements for taking the examination.
The proctor is required to have e-mail and Internet access.
The proctor must verify the identity of the student by requesting an acceptable form of photo I.D., such as a valid driver's license.
The student may not view the examination prior to the date/time arranged for taking the examination.
The proctor must provide an appropriate location for taking the examination, free of distractions and comfortable for test taking.
The student is responsible for bringing any necessary supplies, such as pens, pencils and blank paper.
The student is only allowed to use any resources indicated on the exam information form while taking the examination. Additional resources are prohibited.
The student should not be left unattended at any time during the course of the examination.
The student is not allowed to copy any questions down during the examination for use thereafter.
The student must adhere to the time limit restrictions on the examination.
The proctor is responsible for returning the examination.
The proctor must adhere to any procedures as outlined.

By submitting this form, I affirm that I am not a relative of this student, and that I have no vested interest in the outcome of this examination. I agree to monitor the student and certify that the student will not use inappropriate or prohibited aids while the examination is being taken. I will ensure that the student will accurately complete the examination.

    Student Information

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    Proctor Information

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