Testing Center Information Form
&
Academic Integrity Affirmation
For Paper Tests Only
X
Section
PRINT Student Name Above
(1) Instructor: (2) Course
NOTE TO FACULTY: Complete fields (1), (2), and (3).
Print a copy for each paper test (25 students = 25
copies). Do NOT complete the student name field.
Attach one to each test copy as a cover page. Submit
w/tests to the Testing Center with Test Control Form.
The Testing Center provides these for online tests.
(3) Test Name, Number or Chapter(s)
(Must Match Test Control Form)
I attest that I have not violated the Prince George’s Community College Standard of Student Conduct,
the Code of Academic Integrity, or the Testing Center Rules on this test/examination. I understand that
if I violate the Standard of Student Conduct, the Code of Academic Integrity (outlined in the Student
Handbook), or any of the rules of the Testing Center, I will receive a “zero” on this test/examination and
will be referred to the Department Chair, Dean, and/or Vice President for Student Services for
disciplinary action.
X
Student Signature Date
...........................................................................
Entire Right Corner Area
Reserved For
Testing Center Labels
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