To be completed by proctor:
By my selection below, I verify my current position as one of the following:
Teacher, administrator, or counselor (at a school, community college, or university)
Librarian
Administrator in training or human resource personnel department
Military education officer/testing center supervisor
I am not a graduate student, student's supervisor, personal friend, or relative. Proctors who do not fit the above description will be refused.
I agree to proctor examinations for the person (s) listed below who are taking online courses from Coffeyville Community College. I will see that the examinations are administered honestly and according to directions. I recognize the examinations are copyrighted and confidential and agree to keep them secure and to allow no one but myself and the student to access to the exams. Further, I agree to return the exam myself and will not allow the student to be in possession of the exam once it has been administered. I will return the exams immediately to the Director of Distance Education at Coffeyville Community College. I understand that I will not be paid for this service, but I will proctor these examinations to help the individuals involved.
Name:
Position or Title: Email:
Name of Company or Institution:
Company or Institution Mailing Address:
City: State: Zip Code:
Telephone Number: Fax Number:
Name of Student:
Thank you for helping this student. The form will be submitted to the Director of Distance Education at Coffeyville Community College.
