BYU Independent Study

Proctor Application Form for High School Counselors and Teachers

Information

* All fields are required.

Name of High School
Address of High School
ACT Code (optional)
Your First Name
Your Last Name
Birthdate	(mm-dd-yyyy)
Email
Phone
Do you charge a fee?	yes no	fee amount $
Are you willing to proctor for students not at your school?	yes no
Please select your title.
Proctor Policies and Procedures BYU Independent Study reserves the right to deny certification to any individual who applies. Proctors may NOT be any of the following: University professors Elementary School educators and counselors Relative or friend of student Employer of student Personal tutor of student Ecclesiastical leader * Athletic coach, assistant coach, athletic administrator, or athletic academic counselor Someone with an invested interest in the student's eligibility to compete in extracurricular activities (e.g. sports, theater, choir, etc.) * Ecclesiastical leaders who are also full-time educators ARE eligible to become certified proctors. I certify that none of the above applies to me. I certify that I am NOT an athletic administrator, or athletic academic counselor. Whether it be part-time, I am not in any of these positions.
The student must remain under the supervision of the proctor for the entire duration of the exam. If the student is uncomfortable with the proctoring situation (e.g. the setting is one-on-one with the proctor), a parent, friend, or chaperone may be present, along with the proctor, so long as the student does not interact with that person during the exam. Receiving assistance from any person during an exam is considered cheating and is grounds for receiving a failing grade for the course. The student may not leave the room during the examination, except for an emergency. The exam must not be duplicated in any way. As the proctor, please mail back the exam. Never give the exam back to the student to mail. If for some reason you are unable to proctor an exam after receiving it, please call the Independent Study Office (1-800-914-8931). Do not give the exam to another person or the student. If the student is suspected of cheating, call the Independent Study Office as soon as possible. You will receive more instructions for administering the exam when the exam is mailed to you. I certify that I have read the above policies and procedures and that I will follow them to the best of my ability. I certify that I will be able to remain in the room with the student or otherwise be able to monitor the taking of exam through the entire duration of the exam.
If you do not meet the above criteria and would like to explain possible conflicts, please use the box below.