PAFVETD01_PAF
PROCTOR ACCEPTANCE FORM
VETERINARY TECHNICIAN
I agree to serve as a proctor for the semester examination of the student listed below. I certify that I am not
elated to the student and I am not the student's classmate or employee.
Proctor Information(Please print)
Name ____________________________________________________________________________
Address _______________________________________________________________
_______________________________________________________________
City _____________________________________________ State___________ Zip_______________
Daytime Phone Number ______________________________
Email Address _____________________________________
Proctor Signature _________________________________________________ Date________________
Educational Background:
__________________ _________________________ _________ XXXXXXXXXX____________ ____________
NOTE: When the student completes the required coursework, a sealed proctored examination will be sent to you.
The proctored examination is a combination of timed, closed-book and open-book exams (usually 5 to 6 hours).
The students may use their textbooks for the general education courses but may not use any textbooks for the
veterinary technician courses. The proctored examination must be administered in one sitting within three weeks
of receipt. If you change your address, please notify the student so that he/she may contact the college.
It is imperative that you are able to be present for the entire exam. The exam cannot be given to the student prio
to the scheduled sitting. The exam or exam answers cannot be duplicated under any circumstances. Failure to
abide by all proctoring procedures could result in an invalid exam for the student.
FAX to XXXXXXXXXXor email to XXXXXXXXXX and include “Proctor Form” in subject line.
Note to Student:
I have
iefly explained what is expected of a proctor and certify that the candidate listed above is not related to me
and is not my classmate or employee.
Student’s Signature and Date ________________________________________________________________
Student ID Number ___________________________________________________________________________
Student Name ________________________________________________________________________
Student Address ___________________________________________________________________________
____________________________________________________________________________
( )
PA
FV
E
T
D
01
College City/State Year Type of XXXXXXXXXXMajo
Graduated XXXXXXXXXXDegree
PAFVETD01_PAF
PROCTOR ACCEPTANCE FORM
VETERINARY TECHNICIAN
I agree to serve as a proctor for the semester examination of the student listed below. I certify that I am not
elated to the student and I am not the student's classmate or employee.
Proctor Information(Please print)
Name ____________________________________________________________________________
Address _______________________________________________________________
_______________________________________________________________
City _____________________________________________ State___________ Zip_______________
Daytime Phone Number ______________________________
Email Address _____________________________________
Proctor Signature _________________________________________________ Date________________
Educational Background:
__________________ _________________________ _________ XXXXXXXXXX____________ ____________
NOTE: When the student completes the required coursework, a sealed proctored examination will be sent to you.
The proctored examination is a combination of timed, closed-book and open-book exams (usually 5 to 6 hours).
The students may use their textbooks for the general education courses but may not use any textbooks for the
veterinary technician courses. The proctored examination must be administered in one sitting within three weeks
of receipt. If you change your address, please notify the student so that he/she may contact the college.
It is imperative that you are able to be present for the entire exam. The exam cannot be given to the student prio
to the scheduled sitting. The exam or exam answers cannot be duplicated under any circumstances. Failure to
abide by all proctoring procedures could result in an invalid exam for the student.
FAX to XXXXXXXXXXor email to XXXXXXXXXX and include “Proctor Form” in subject line.
Note to Student:
I have
iefly explained what is expected of a proctor and certify that the candidate listed above is not related to me
and is not my classmate or employee.
Student’s Signature and Date ________________________________________________________________
Student ID Number ___________________________________________________________________________
Student Name ________________________________________________________________________
Student Address ___________________________________________________________________________
____________________________________________________________________________
( )
PA
FV
E
T
D
01
College City/State Year Type of XXXXXXXXXXMajo
Graduated XXXXXXXXXXDegree