Advising and Testing Center
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ACCUPLACER Proctor Security Form ● Please sign and FAX to (907) 786-1674 or 4519
Accuplacer Rules and Regulations (Important, please read carefully)
All tests must be delivered to the tester in a secure and proctored environment. Acceptable locations include community
and four year college settings, post secondary school environment, libraries, military establishments, high school, etc. No
Accuplacer test is to be given by a relative, friend, supervisor, etc. No Accuplacer test is to be given in a private home,
only in a professional proctored environment. If these Accuplacer Rules and Regulations are not followed, the University
of Alaska Anchorage will make the student score invalid and it will be cancelled. The University of Alaska Anchorage
assigned username and passwords are unique to each proctor.
It is the proctor’s responsibility to protect the
confidentiality of this information and its unauthorized disclosure to the tester and/or any other individual.
Have the tester show Photo ID at the time of testing. This is an un-timed test, but the tester should follow your testing
hours. A break may be taken if requested. No calculators are allowed but scratch paper is fine. Once the tester has
completed the test, collect the scratch paper and print a copy of the score report for the tester’s records.
Agreed to and accepted by:
Printed Name of Designated Test Proctor__________________________________________________________________________
Email: ___________________________________________________________________________________________________________________
Phone: ____________________________________________________________________________________________________________________
Today’s Date & Time: __________________________________________________________________________________________________
Proctor Signature: ______________________________________________________________________________________________________
Student’s Name and ID Number: ______________________________________________________________________________________
Printed Name of UAA Advising and Testing Center Staff reviewing this document:
______________________________________________________________________________________________________________________________
Signature of UAA Reviewer and Approval: __________________________________________________________________________
Date & Time of UAA Review and approval:
_______________________________________________________________________________________________________________________________