Proctor Application and Qualifications Form

Program candidates must identify and secure a qualified individual to serve as Proctor and oversee the examination process ensuring the highest level of integrity and honesty is maintained throughout this process.

Please complete the Proctor Information below:

Name:
Position/Title:
Agency/Organization:
Business Address:
City/Town:
State: Zip/Postal:
Business Phone: Extension:
E-mail Address (required) Business Fax:
Relationship to Student:


To qualify as a proctor, the individual must meet one of the criteria listed below. Please select only one.

Supervisor Certified Protection Professional Official Learning/Tutoring Centers
General Manager Certified Protection Officer Member of a recognized Policing Organization
President/Vice-President or Officer of an organization or company Certified Fraud Examiner Librarian
Certified Security Trainer Human Resource Officer Dean, Academic Department Head, or Official Testing Service of an Accredited University or College
Military testing site Corporate Instructor University/College Faculty Member
Military Educational Officer Staff Development Officer Member of a Professional Security Association
Law Enforcement Officer Member of the Clergy Other (specify): requires permission

This form may be printed and when completed mailed or faxed to:

International Foundation for Protection Officers  
P.O. Box 771329  
Naples, FL. 34107-1329 Fax to: (239) 430-0533
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