Proctor Agreement | Information Technology Services

Please review the Proctor Agreement information below and Article III, Part B 1-4 found on pages 3 & 4 of the Student Code of Conduct before filling out the information below.

By checking the "I Agree" box below, you are accepting all terms and conditions stated above.

Required fields are marked with an asterisk *

Students or prospective proctors should fill this form out and submit it at least one week prior to the first exam date.

Once the form is received, CTT staff will check to make sure the proctor meets the criteria that is listed on the Agreement Form. If they are approved, an email containing the login information, which should be used for all exams during the current semester/session, will be emailed to them.

If the proctor does not meet the criteria, the student will receive an email letting them know why the proctor was not approved and suggesting that they find a different proctor. If the student has more questions, they should contact the CTT staff to receive assistance.

Proctor Agreement

First Name Required

Middle Initial Required

Last Name Required

Position/Title Required

School/Organization Information

Exam Information is sent only to a school, institution, or organization email address. Complete contact information is needed as part of the verification and exam dissemination process.

Address 1 Required

Address 2

City Required

State Required

Zip Code Required

Proctor Work Phone Required

School/Organization Email Required

I certify that I am not (check all that apply)

A relative to the student I will proctor Required

A supervisor of the student I will proctor Required

I certify that I meet the following criteria.

Select one

Individual active in the educational field (elementary, secondary, or college) as a teacher, a counselor, librarian, extension agent, or an administrator at any level, unless otherwise directed by the course instructor.

Supervisor of local testing center

Test control officer or superior commissioned officer serving as a proctor for military personnel

American embassy or consular official

Nebraska Extension Educator

Student Information

First Name Required

Middle Initial

Last Name Required

Student Email Required

Course Required

First Exam Date

Agreement

Yes, I agree.