# Supplemental Application - Disability Resource Center

```Disability Resource Center 146 Hahn Student Services (831) 459-2089
Exam Assistant Applicant Information
Supplemental Application
Name: ______________________________
Student ID# ____________________________
GPA: _____________ (Must be 3.0 or above to be eligible)
College: ___________________________
College Level: FR SO JR SR (circle one) Major: ___________________ Minor:_______________
Be advised the following information will be shared department exam coordinators and clients:
Phone: __________________________________ type: _______________
1. List three traits that would make you a good Exam Assistant:
1.
2.
3.
2. Please write the following passage on the lines provided:
“It was the best of times, it was the worst of times; it was the age of wisdom, it was the age of foolishness; it
was the epoch of belief, it was the epoch of incredulity; it was the season of Light, it was the season of
Darkness; it was the spring of hope, it was the winter of despair; we had everything before us, we had
nothing before us; we were all going direct to Heaven, we were all going direct the other way.”
3. Draw a figure in each of the boxes from the following instructions:
“Make three circles evenly spaced in one row. Label them a, b, and c across the bottom of the box. All the circles
should be the same size. Draw a dotted line across the middle of each circle from top to bottom. Draw an arrow
between a and b, pointing from a to b. Draw an arrow between b and c, pointing from b to c. Draw another arrow
between b and c, this time pointing from c to b below the arrow you already drew.”
“Make an upside down U about an inch high on the far left side of the box. Draw three pea size circles in a line like
Orion’s belt in the middle of the box. Draw a large circle, about the same size as the upside down U, on the far right
side of the box. Draw a line from the center of the circle to the left edge of the circle towards the little circles at about
the middle of the circle. Draw another line from the center of the circle to the edge of the circle sort marking
south/west. Draw a chevron line at the bottom of the upside down U connecting one end to the other.”
-BASIC AGREEMENT-
● I agree to keep all information regarding my test-takers confidential as well as any other information I may see or overhear
while in the DRC office.
● I understand that this is an on-call position, work hours are not guaranteed.
● I agree to promptly respond to e-mails from the DRC inquiring about my availability to work exams with one of these
responses: 1) I am available, 2) I am not available, or 3) I am available but do not have the required subject area
knowledge.
● I understand it is my responsibility to update the Accessible Technology Coordinator with any schedule changes
immediately.
● I agree to submit time sheets on a by-weekly basis, even if I have worked no hours (report “.25” hours), on a timely basis.
● I agree to check-in at the DRC 45min prior to any assigned exam, and arrive promptly to the exam room 15min. prior to
the scheduled exam start time.
● I agree to maintain an appropriate test environment and observe proctoring protocol.
● I agree to provide unbiased scribe/reader services without making editorial changes or personal judgments.
● I agree to deliver completed exams to the designated location, sealed in the envelope provided, immediately after the
exam is completed and submit appropriate paperwork to Adaptive Technology Coordinator for data entry and service
tracking.
● I agree to complete employment forms at Career Services if not currently in the University Payroll System (PPS).
● I understand I can not work or be paid if I am not enrolled in the University Payroll System (PPS).
● I understand that if I am a non U.S. citizen it is my responsibility to inform Career Services and provide appropriate
documentation of eligibility to work when completing employment forms.
I have read and understand the Exam Assistant Applicant Information Sheet. I have read and understand the above
policies.
A
Exam Assistant Signature
Date
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