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Student Information Form2 - All of the information...

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Student Information Form Columbia College - Online Education: Western Civilization This course requires that the final exam be monitored by a proctor approved by the instructor. Failure to submit this form by the end of the second week of the course may result in you being denied access to take the final exam in which case the default grade for the exam will be zero. The easiest way to get an approved proctor is to schedule it through a Columbia College campus near you; this will automatically be approved. If you are within a one hour drive of a Columbia College campus this is the required proctor for your tests. If you are further than one hour away from a Columbia College campus you may request an alternate proctor. This will require that you submit additional information about your requested proctor. This person will be contacted and evaluated as a potential proctor for your exams. The acceptability of a person as a proctor is at the sole discretion of the instructor. The syllabus describes who is acceptable and unacceptable as a proctor.
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Unformatted text preview: All of the information requested in the first section of this form must be provided . Section I: General Information (answers required from ALL students) : Course number and section letter: HIST 102 Date Form Submitted: June 2, 2009 Your Name: Thomas Marler Your Phone number: 573-289-7036 Closest Columbia College campus: Home Campus Drive time to campus: 5 min Do you intend to have your exam proctored at above campus? YES Section II: Answer ONLY IF proctor is NOT at a Columbia College site : Requested Proctor Name: Proctor Phone Number: Proctor email address: Functional Title of Proctor: Relationship of Proctor to you: Why can’t you use a Columbia College site? Section III: Essay Information Are you willing to allow the instructor to post any of your essays for the class to read as an exemplary essay? Yes_____x___ No_______ If so, do you prefer to have it posted anonymously, or with credit to you? Anonymously____x___ With credit________...
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