Proctor Approval Form

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Proctor Approval Process

Student Information

Student Name

PSU ID

Phone

E-mail

Instructor Information

Instructor Name

Course Number and Section

Proctor Information (Relatives and friends are not suitable proctors)

Has this person previously served as a proctor?

Yes No

Proctor Name

Position/Title

Business/Library/School Name:

Business/Library/School Website:

Business Address

Street:

City:

State:

Zip:

Business Phone Number:

Email Address:

Verify Proctor Information
Upload a document that verifies your proctor's identity (letter, letterhead, etc.)

Is this person able to proctor online exams?

Yes No

Is this person a friend or relative?
Please note: Relatives and friends are not suitable proctors, and the use of an unauthorized proctor is considered an act of academic dishonesty

Yes No

By agreeing, I certify that the enclosed information is true and legitimate, and complies with the corresponding guidelines outlined by course and University policies, and that the proctor is not a relative or friend. Failure to abide by course and University policies on academic integrity will be reported to the College of the Liberal Arts, and academic sanctions may fall upon me.

Please indicate your agreement with the above statement.

I agree

Please type your full name as your electronic signature. By typing your name on this agreement, you agree to abide by the letter and spirit of this policy.

Spanish Basic Language ProgramDepartment of Spanish, Italian, and Portuguese

Proctor Approval Form

Student Information

Instructor Information

Proctor Information (Relatives and friends are not suitable proctors)

Business Address

Department of Spanish, Italian, and Portuguese

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