DEPARTMENT OF MATHEMATICS

401 Mathematical Sciences, Stillwater, OK 74078-1058

Tel: 405-744-5688 Fax: 405-744-8275

Distance Learning Programs

MATH 4023 PROCTOR AGREEMENT
Summer 2019

Dr. Mantini requires a face-to-face proctoring/testing center for the three exams in this course. The
testing center for this course may be
. a testing center on any college or university campus;
. an instructor at a local college or university;
. an administrator at a local public school.
. Students on the OSU/Stillwater campus may attend exams scheduled by the instructor (see
course syllabus for dates and times) or may contact Mary Johnston in the Math Department (405-
744-5688) to schedule make-up exam times. Students may also use the fee-based testing center on
the OSU-Stillwater campus at University Assessment and Testing, 1524 W. Admiral.
. Please return this signed agreement to Dr. Lisa Mantini, lisa.mantini@okstate.edu, in person
at 410 MSCS, or fax it to 405-744-8275.
Student’s Name and Email address:

Student’s city and state in which testing will be completed:

If not in Stillwater, OK, please complete the rest of this form.

Proctor’s Name and Title:

Phone and email address:

Employer’s Name and address:

Relationship to student, if any:

I hereby agree to proctor tests taken by the above named student according to the guidelines pro-
vided by the instructor, and I will certify that each test was administered in accordance with the
guidelines supplied to me. Examples of guidelines include permitting the student to use only the
allotted time to take the test, and not allowing the use of any notes, reference materials, phone or
internet access, or other means of assistance. I understand that exams will be delivered to me as a
pdf attachment to an email. I will keep the exam confidential until it is printed out and administered
to the student. I will collect the paper test at the end of the specified time, will sign that procedures
were followed, and will scan and return the exam as specified.

Proctor’s signature and date: