Complete the  box by entering your name, email address, postal address and phone number.  Send the information to your instructor by clicking on the "Submit Answers" button at the end of the proctor form.

All proctors must be librarians, military educational officers, college professors, professional proctors (such as our lab aides) or clergy.

Examples of approved proctors are college teaching faculty members or faculty librarians. Friends, supervisors, and family members are not suitable proctors.

The proctor must have a professional email address and phone. (hotmail, yahoo, excite, aol, netscape, earthlink, verizon, netzero email accounts are unacceptable).

The email address must correspond to a school or business.

All proctoring at Barstow Community College must be done by our designated proctors in the Computer Commons.

You will also have to secure an approved site, such as a college classroom, library, education center or church office at which to take the exam.

All students are required to take the exams at an adequately supervised location.

ATTENTION:  This is a form to be filled out by students who require proctoring for their tests.  Needs to be completed by no earlier than the second week, but no later than the the first day of the third week of class. If you are able to come to the scheduled exams you do not have to fill out this form.

In addition filling out this form does not automatically mean your proctor has been accepted.  The proctor will still need to receive instructor approval.  

Finally please remember that the top box is for YOUR information and the bottom box is for your PROCTOR'S information.  You can not be your own proctor.  A proctor for this class must be unrelated to you, and be approved by the instructor.  Any costs related to proctoring are to be born by the student.  The college is not responsible for proctoring fees.

Student Name:		(Always use your real name in this box)
Student Email:		(Enter your exact email address)
Student Postal Address:	Number & Street	Student Telephone Number:
	City, State, ZIP

Proctor Name:		(Always use your  proctor's real name in this box)
Proctor Business Email:		(Enter your  proctor's exact business email address)
Proctor Postal Address:	Number & Street -- no P.O. Boxes	Proctor's Telephone and FAX Number:
	City, State, ZIP
How does your proctor qualify? (Job Title: instructor, librarian, clergy)
What is your approved location? (college, library, church)
Has this person agreed to proctor your test?		yesno

After filling out this form, copy the confirmation page and send it via email to sbulkley@barstow.edu.