Proctor Record Oath - Rev Carlisle (Autosaved).Xlsx

Proctor Record Oath - Rev Carlisle (Autosaved).Xlsx

Industry Certification TestingProctor Record- Career and Technical Education

School Testing Site ______Program______Certification Exam ______

Date______Room Number______Test Code______Score Required to Pass Exam______

This form is to be sent to the Career and Technical Education Department for each testing session along with the official documentation from the testing/certifying agency for students who sat for the exam.

Proctor Instructions:

1.ONLY STUDENTS WHO ARE TESTING are to be in the testing area ‐ no exceptions.(Note: The area may be a classroom or a section of a classroom dedicated to testing.)

2.List the names of all students testing on back of this paper. (Legal names as listed in Skyward ‐ no nicknames.) Additional forms may be used if needed.

3.Have student(s) initial by their name, once they have verified spelling.

4.Cross through the name(s) of student(s) who are not present when the test begins.

5.Do NOT allow students access to testing materials prior to testing date and time.

6.Keep the students under DIRECT OBSERVATION by the independent observer at all times during the testing period.

7.Adhere to all established testing procedures, including those required by the specific certifying entity.

8.Provide special accommodations for test candidates with special needs (refer to testing agency contact and accommodation guidelines).

9.Keep all testing material secure, before and after testing, to preserve the integrity of the test.

10.Follow established procedure if testing protocol is compromised in any way.

11.Report breaches in testing protocol to Director of Career and Technical Education within one business day of occurrence.

NOTES:* The test proctor MUST BE qualified to proctor the test.

* An independentadditionalproctor is REQUIRED if the certified proctor teaches any course in the CTE program associated with the test.

* Proctors must sign each page on which a student’s name appears to verify their presence at testing.

Proctor Oath:

By signing below, I attest that I have read and that I understand the proctor instructions. I understand that the independent proctor may not be a teacher of record in the Academy associated with the test. I understand that I must preserve the integrity of the test and testing materials. I understand that failure to follow protocol may jeopardize the validity of the test.

Teacher: ______


Proctor Name: ______





Number of Students Tested:______# Students Who Passed:______# Students Who Failed:______

Student Name as Listed In Student Record System / Student Initials / Course Number / Section # / Pass / Fail

Proctor:______Signature:______Indep Proctor:______Signature: ______


Page __ of __ (use page 2 template for all additional pages; each must be signed by proctors)rev 4/21/15