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IFPO CANDIDATE/PROCTOR VERIFICATION FORM
| Candidate name: |
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______________________________________________________ |
| Social security #: |
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______________________________________________________ |
| Course title: |
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______________________________________________________ |
| Exam format: |
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______________________________________________________ |
|
|
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| Proctor name: |
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______________________________________________________ |
| Date of examination: |
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______________________________________________________ |
| Location of examination:
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______________________________________________________ |
| Time exam began: |
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______________________________________________________ |
| Time exam completed: |
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______________________________________________________ |
Proctor guidelines:
Please verify that you have
adhered to
following guidelines :
| ____ |
Candidate's identity was verified by photo ID |
| ____ |
Candidate did not preview the examination prior
to taking it. |
| ____ |
Candidate did not use any resources, textbooks,
notes, or any other course materials unless instructed to in the directions
of the examination. |
| ____ |
Candidate was never left unattended at any time
during the examination. |
| ____ |
Candidate adhered to the time limit restrictions. |
Statement of verification:
| I, the above named candidate,
hereby certify that I have independently completed this examination under the
supervision of my designated proctor. I completed this examination without the
use of any books, notes, or items, except those specifically permitted for use
during this particular examination. |
| Candidate name: (print) |
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______________________________________________________ |
| Candidate signature: |
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______________________________________________________ |
| I, the above named proctor,
hereby certify that I have supervised the administration of this particular
examination. The above named candidate has completed this examination following
all regulations as outlined in the proctor guidelines. |
| Proctor name:
(print) |
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______________________________________________________ |
| Proctor signature: |
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______________________________________________________ |
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