Fillable Proctorapplication 040518 (Commonwealth of Massachusetts)

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Proctorapplication 040518 (Commonwealth of Massachusetts)

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U.S.A. forms for Commonwealth of Massachusetts

BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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Commonwealth of Massachusetts
Board of Bar Examiners
Proctor Application
www.mass.gov/bbe
Please print legibly:
Name: ____________________________________________________SS#: ___________ -___________-____________
Address: _________________________________________City/State/Zip: _____________________________________
Telephone – Home: ________________________Mobile: ________________________Work:______________________
Email Address
(required):_______________________________________________________________________________
Emergency Contact: _______________________________________________Contact Tel. No._______________________________
Please complete the following questions:
1) Are you able to work the _____February exam _____July exam _____ or both exam(s)?
2) Have you proctored examinations before? _____ Yes _____ No Are you presently employed
? _____ Yes _____ No
If yes, please detail your proctor and/or work experience:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
3) Are you at least 21 years of age and a high school or college graduate with no criminal record? _____Yes _____ No
4) Are you proficient in the English language with an ability to communicate clearly and effectively? _____ Yes _____ No
_____Yes _____ No
_____Yes _____ No
5) Are you able to stand and walk up to 80% of the time throughout the testing sessions?
6) Are you able to lift 20 lbs. and work a 10-12 hour day?
7) Do you require accommodations in order to meet the responsibilities of a proctor?
_____Yes _____No
8)
9)
If yes, please describe the accommodations required.
______________________________________________________________________________________________
______________________________________________________________________________________________
Are you related
to any Bar Examiner or employee of the BBE? _____Yes _____No
Are you related to anyone presently attending law school or taking the bar exam or a law school employee or bar exam
tutorial company?
_____Yes _____No
If yes, please provide detail:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
10) Do you meet all the requirements listed in the Bar Examination Proctor Job Information document? _____Yes _____ No
11) Do you have any of the following qualifications or skills? Please check all that apply.
□ First aid, CPR, or health care professional;
□ Experience as a security guard or monitoring large groups of individuals;
□ Experience with proctoring exams administered on computers;
□ Experience as a reader or scribe or working with examinees requiring accommodations
□ Experience as a teacher or trainer or working as a supervisor;
□ Other special skills. Please describe: ________________________________________________________
_______________________________________________________________________________________
12) How did you learn about this position?
□ BBE Website □ Relative/Friend/Proctor* □ State’s Job Site □ Other – Please list__________________
*Please insert name: ___________________________________________________________________________
I understand that completing this application does not ensure proctor selection for proctoring at the bar exam. Decisions are
made for each exam based on level of experience needed and the number of open positions available for the specific exam.
Signed
: _____________________________________________
Dated
: ____________________
Application Process
Send the completed application to:
Board of Bar Examiners, Edward W. Brooke Courthouse, 24 New Chardon Street,
1st Floor, Boston, MA 02114. The Board will review your application and upon acceptance will notify you via email.
For more information visit www.mass.gov/bbe
or call (617) 482-4466.
---------------------------------------------------------------------------------------------------------------------------------------------------------------
For BBE Use Only
□ Feb. □ July □ Both Vendor Code:_________________________________________
□ Boston □ Springfield □ W-9 □ T & C □ EFT □ Access dB
Identification Verification:
Document Title: ____________________________________________________________ Issuing Authority: ___________________________________
Doc
ument Number: _________________________________________________________ Expiration Date: ______________________________________
Approv
ed by: _______________________________________Date:____________________
--------------------------------------------------------------------------------------------------------------------------------------------------
Rev. 4.18
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Proctorapplication 040518 (Commonwealth of Massachusetts)

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Completed 26 July 2020

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