ELI Proctor Request - PDF document

NOVA Onlines Proctor Request form is now electronicGo to https://dashboard.nvcc.edu/forms/ProctorRequest/ to access the new electronic version. If you have trouble using the electronic version, you can still use the .pdf version. See the instructions and form in the following pages of this document. 1 Rev /1 Proctor Request Instructions Thank you for choosing Northern Virginia Community College (NOVA) online courses! Please read the information below and accurately complete the proctor request form to take exams. Who needs a proctor? metropolitan area are required to take another college or university center, or through our online Proctors will not be approved based solely on student preference. reserves the What I have uestions? If you have to check the status of a 2 Rev / Where should I take my exam? Northern Virginia/Washington DC metropolitan area residentsyou are required to take your exam at a NOVA testing center or to use our online proctoring service, ProctorU,it is available in your course Other Virginia residentsYou may take your exams at any Virginia Community College testing center, via our online proctoring service, ProctorU, if it is available in yourcourse, or at the testing center of another Virginia college/university at which you are astudent (submit a proctor request for approval). Use the College Locatorfeature on theVirginia Community College System (VCCS) website to find a college near you. http://www.vccs.edu/ . Students in other statesYou may take your exams at a college/university testing center near you (submit a proctor request for approval), or via our online proctoring service,ProctorU, if it is available in your course Proctor requirements: Must be a testing center at an accredited college or university.In documented mitigating circumstances, a full-time faculty member at an accreditedcollege or university may be eligible, provided we can verify their employment status andexams are taken at a college or university office with a computer provided by the testproctor.Active Duty and deployed military personnel may submit a proctor request for anapproved military educational or test control officer. Proctors cannotbe a family member, employer, friend, co-worker, or someone with whom the student has any personal relationship. Proctors also cannotbe an adjunct faculty member, teaching assistant, athletic coach, or student worker. Exams may notbe proctored at the home of the student or proctor, or using a personal computer provided by the student. tudents requesting esting ccommodatimust haveon file with the Office isability ervices prior to taking xams. Accommodations are not retroactive and will not be granted without following the process as outlined by Office of Disability Services. Accommodations must relate to online courses. may provide a directly to to discuss appropriate proctor accommodations. ��3 Address verification If you have a ginia ddress and are equesting a tor outside Virginia or the Stateyou will ect to address verification and domicile eview. Also, any requesting exam to be sent to a different region, state, or ountry that does not align with the ddress listed in the student information system will be subject to address verification and must provide documentation to support their request. provals ommunicated? For pproved requestsexams will be mailed mailed roctorstudents will receive an email onfirmationat their student email address (@email.vccs.edu). Directions STUDENTSComplete ection 1on the following give the orm tthe college university entemilitary ducational or test control officer oproctor (you have a documemitigating circumstance). PROCTORSComplete ection 2and prepare a your institutional letterheawith the gree to serve s proctor for s namexatored at (computer provided by fice (or testing centerave no personal oprofessional affiliation with the student and understand that I ay not make ny lterations to the exam instructim provided for s studeI certify that the informatirovided on the Proctor Request Form is correct.” *Submit the itutional letterhead, with an original signatureyour professionalcontact information, adate.Keep this page for yreference. Continue o proctor request form on page Submit pages 4 and 5 for processing of your request. 4 Rev /1 SECTION 1:STUDENT ATIONMy eason for requesting a tor is (please heck one): I am located outside the Northern Virginia/Washington Metropolitan area. I am active litary r deployeand unable to travel to campus. ave ability illness whicprevents me rom traveling campus. (Please evieguidelines Students Needing Accommodationsinstructions.)Student EMPLI______________________________________ Date: ___________________ Student’LegaName:___________________________________________________________ Address: _________________________________ City: ____________________ State: __________ Country: _____________________ Zip Code: _______________________ Courses to be tored: Is this the first time you have _____Yes _____ No VCCS ess:___________________________________________________________ Phone r:______________________________ Best time to reacyou:________________ Academic Integrity Statement: By itting s form, I attest that all proctor information contained on this form is correct and conforms to the guidelines set forth by the Collegerstand that any eliberate misstatement act may result in referral to the Student Conduct Process and a grade f “F” ing assigned for any all oursespast and presentin which examinations were en under such misstatement. nature: _________________________________________________________________ original signature typed signatures will not cepted ��5 SECTION 2: ROCTOR INFORMATION Proctor’s Name: _________________________________________ Da__________________ ProfessionaTitle:_______________________________________________________________ Organization: __________________________________________________________________ Work phone________________________Work eExams winot be sent to pemail addresses such as yahoo and hotmail.)WorAddress: __________________________________________ City: ________________________________ State: ___________ Zip Code: _______________ Countrif not in United State____________________________________________________ Locatiwherxams witored if different than work address: ______________________________________________________________________________ SECOMPLETED FORM, THPROCTOR’S STATEMENT ON LETTERHEAD, AND MEDICAL DOCUMENTATION IF PPROPRIATE. Submissioof completed requests: ubmissionaishoule scanneanailitthe appropriate originaignatures.)