1211 South Glenstone Avenue
Springfield, Missouri 65804 USA
GRADUATE SCHOOL OF THEOLOGY
EXAM SUPERVISOR APPLICATION
INDEPENDENT STUDY STUDENTS ONLY
Phone: 1-800-443-1083 (USA); 417-862-9533 (outside USA)
Fax: 417-862-0863; E-mail: firstname.lastname@example.org
NOTE: Only students who are enrolled directly through the International Graduate Studies Center should use this form. Students enrolled
through a Graduate Studies Group outside the USA should contact their office for exam supervisor information.
Student Name (please print) Student Number Office Code
Suggestions for Exam Supervisor:
A logical choice for a qualified exam supervisor would be an educator or senior pastor in your area. Other qualified exam supervisors
could include, but are not limited to, teachers, librarians, school or church administrators, or other professionals.
1. The exam supervisor cannot be related to the student by birth or marriage.
2. The exam supervisor cannot reside at the same address as the student.
3. The exam supervisor cannot be a current Global University student at any level.
4. The exam supervisor must be 18 years of age or older.
5. The exam supervisor must be able to monitor the student while the exam is being taken.
Student Verification of Qualifications of Proposed Exam Supervisor:
My signature below indicates that the requested exam supervisor meets all qualifications to serve as my exam supervisor.
Requested Exam Supervisor (*indicates required information):
*Exam Supervisor name (please print) *Title / Employment
*Daytime mailing address (preferably no PO box) *Employer
*City, State *Daytime telephone
*Zip code, Country E-mail
Responsibilities of an Exam Supervisor:
1. Arrange with the student a time and location to administer the exam. Schedule up to 3 hours for the student to complete the exam.
2. Be prepared to accept and sign for the Global University exam packet when it is delivered to your daytime address.
3. Keep the confidential exam materials in a secure location and ensure the student does not have access to the exam until time to
4. Monitor the student at all times during the examination session and allow the student up to 3 hours to complete the exam.
5. Sign, date, and mail the Exam Verification Form with each completed examination. This verifies that all exam procedures were
followed and the student did not use inappropriate aids such as notes, study guides, textbooks, dictionaries, etc. Note: The completed
exam cannot be processed without this signed document.
6. Return all exam materials by the date indicated on the Exam Verification Form or within 3 days of administering the exam, whichever
7. Return exam materials to Global University via a traceable shipping method such as UPS, FedEx, DHL, or certified mail. The student
should provide shipping cost and a 9-x-12-inch or larger envelope to allow the supervisor to return the verification form and exam
booklet with all student responses, notes, and comments without folding.
Signature Verification of Exam Supervisor Applicant:
I accept the responsibilities of exam supervisor for the above-noted student. I commit to preserve the integrity of the evaluation process
prescribed by Global University and will ensure that all examinations for this student are taken in my presence and in compliance with
*Exam Supervisor Signature Date
Please return this completed application to the student.
Office Use Only
Date Application received Exam Supervisor ID
Exam Supervisor approved Yes No Authorized by:
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