Distance Testing

Proctor Agreement Form

Please print this form.

Fax or mail completed form to:

St. Petersburg College

Electronic Campus
9200 113^th Street North
Seminole, Florida 33772-2800

Contact: Dian Marone
marone.dian@spcollege.edu
Phone: 727-394-6047
FAX#: 727-394-6124

Thank you for agreeing to proctor testing for St. Petersburg College. We appreciate your support in meeting the needs of our Distance Learners. Your name has been provided to us by a student who is requesting to take the placement test from a location other than St. Petersburg College.

Name: __________________________________

Address: __________________________________

__________________________________

Student Name: __________________________________

Phone: ( zzz)_____________

FAX: ( zzz) ______________

Email: __________________________________

Student ID.#: __________________________________

By agreeing to proctor testing for St. Petersburg College, I am indicating I will follow the testing conditions listed below:

Maintain the security of the test by keeping it in a protected environment.

Administer the test in a secure, proctored setting that provides good testing conditions for the examinee. Testing environment will be comfortable, free from distractions, and visually monitored.

Verify the identification of the examinee (Photo ID with signature)

Ensure the security of test questions. Test questions shall not be revealed, copied, or otherwise reproduced. All materials used by the student during testing shall be collected.

Provide no assistance to the examinee in answering the test questions.

______________________________
Proctor Signature

___________
Date