8/17/2017 eg
Testing Center Proctor Form: Rocklin
Assessment/Testing Center
LT-1 Phone: (916) 660-7430
Email: testingcenter@sierracollege.edu
Spring & Fall Hours: Monday-Thursday: 8am – 7pm; Friday: 8am - 5pm
Summer Hours: Monday-Thursday: 8am – 6pm; Closed Friday
Testing Center Policies:
1. Valid photo ID is required for all testing.
2. Only one student per proctor form. A Testing Center Proctor Form must accompany every test or quiz.
3. The Testing Center does not proctor entire classes or online classes.
4. Tests and quizzes will not be accepted via email: All tests and quizzes must be printed and delivered to the Testing Center.
5. The Testing Center will not print tests or quizzes.
6. Student-delivered tests or quizzes must be securely sealed in an envelope with a completed Testing Center Proctor Form.
7. The Testing Center does not allow the use of laptops, cell phones, headphones, smart watches, electronic dictionaries or
other electronic devices. No exceptions.
8. DSPS students are responsible for providing their current DSPS accommodation form during every testing visit.
9. All tests and quizzes will be proctored on a first-come, first-served basis (including appointments for private rooms).
Proctoring Instructions Please print clearly below:
Student Name_________________________________ Instructor Name_____________________________
Student ID #__________________________________ Date Test Begins_____________________________
Course Name & Number________________________ Date Test Ends______________________________
Test or Quiz Name_____________________________ Return Delivery Method
Reason for Test or Quiz:
Missed/Make-up Test or Quiz DSPS Academic Accommodation(s) Incomplete Academic Work
Time Parameters for Test or Quiz:
How much time does the CLASS have for the test or quiz? ______hrs _______mins
Does this student get: Same time as regular class time
Alternate test time amount (include DSPS accommodation) ____hrs ____mins
Test or Quiz Instructions:
What answer materials are allowed for this test or quiz?
□ None Answer on Test or Quiz
□ Bluebook
□ Scantron (specify type) ____________
□ Other __________________________
Are resource materials allowed for this test or quiz? □Yes □No
If resource materials ARE allowed, please select from the boxes below:
Scientific calculator
□ Graphing calculator
□ Dictionary ________________
□ Scratch paper______________
□ Books ____________________
□ Notes ____________________
□ Other ____________________
Instructor Information (required):
Full-Time Faculty (Office Location:________) Part-Time Faculty
Contact Phone Number: (_____)__________________
Campus: Rocklin NCC Roseville Tahoe-Truckee
Instructor Signature (required)____________________________________________________________
□Inter-Office Mail
□Instructor Pick-up
□Student Hand Delivery
For Office Use Only:
Date Delivered:________
Staff Initials:___________
Delivery Method:_______
Additional Instructions for the Test or Quiz:
click to sign
click to edit