Invigilator availability and information form

Name Contact
telephone
Email number(s)

Please insert ainthe white boxes to indicate the period sessions you are available to invigilate on the
dates below

November 2021

Week 1 commencing 1 November Week 2 commencing 8 November

Day Date 1&2 3&4 Day Date 1&2 3&4
Monday 1 Monday 8
Tuesday 2 Tuesday 9
Wednesday 3 Wednesday 10
Thursday 4 Thursday 11
Friday 5 Friday 12
Week 3 commencing 15 November Week 4 commencing 22 November
Monday 15 Monday 22
Tuesday 16 Tuesday 23
Wednesday 17 Wednesday 24
Thursday 18 Thursday 25
Friday 19 Friday 26
Invigilator information

1. Are you related to or have any connection to current students at this centre?Yes/No

If yes, please provide name(s):

2. If required, would you be willing to invigilate a candidate in a separate exam room on a 1:1 basis?Yes/No
3. If required, would you be willing to facilitate an access arrangement for a candidate,for example by acting as
a reader, scribe etc. (training would be provided)?Yes/No

Additional Information
Periods 1 & 2 = 9.10 -11.10 approx
Periods 3 & 4 = 11.30 – 1.30 approx

This document is provided for members of The Exams Office onlyand must not be shared beyond use in your centre
Invigilator availability and information form template (2021/22)