Proctor Selection Form

  

In order to preserve the integrity of this course, I am asking that you take five proctored exams.  The first four are unit exams, and the fifth is the final exam.  Please choose between the following two options, and fill out the appropriate section of this form.  Return this form to me no later than two weeks after the start of the semester.

 

Return this form to me via U.S. Mail at the following address:

 

Professor Mona Baarson

Mathematics Department

Jackson Community College

2111 Emmons Road

Jackson, Michigan  49201

 

Option 1:    On-Campus Option:

 

You can take your exams in the testing lab on JCC's campus. 

 If you select this option you will need to go to the testing center in the LRC (library), which is located in Bert Walker Hall, Room 100-D, on main campus.  The exams will be placed in the lab approximately one week before the due date, and you may take them whenever the lab is open (8am-9pm Monday through Thursday, 8am-noon Friday, 1 – 5 pm on Sunday).  Simply walk in and request the test from the lab consultant; it is filed under my name, Mona Baarson, and our class number, MTH 140-Online.  You will be asked to verify your identity by showing a photo ID with that identifies your full name (both first and last names).  The consultant will show you to the testing room, and you can return the test to the consultant when you are finished.  I will pick up completed tests from the lab at closing time on the due date.

                  

I elect Option 1 as the format in which I will take all of my exams.

 

Student's Signature:________________________________            Date:_____________________

 

Option 2:    Off-Campus Option:

 

You can find your own proctor.  If you select this option, you will need to find someone who is willing to proctor your tests.  This person must be a professional educator (teacher, principal, etc…), clergyperson (pastor, priest, etc…).  Your exams will be sent directly to your proctor, who will be asked to verify that you have adhered to the rules on the cover sheet, seal your completed test in an envelope, sign across the seal, and mail it to me by the due date. 

 

I elect Option 2 as the format in which I will take all of my exams.

Proctor’s name: _____________________________________

Proctor’s employer: __________________________________

Job title:  ____________________________________

Business Phone:  ______________________________

            Proctor’s address (where tests should be sent):

                       ___________________________________________

                        ___________________________________________

Proctor’s Signature:  _________________________________

Student’s Signature: __________________________________

            Date:_____________________