Test Administrator/Proctor Incident Report Form

Test Administrator/Proctor Incident Report Form

Test Administrators/Proctors must complete and submit this form to CASLI as soon as possible after any and all incidents that occurs during the administration of an exam. If no incident is reported, it will be assumed that no incident occurred.
Test Administrator / Proctor Name:*

First NameLast Name
Email*
example@example.com
LTA Site Name *
LTA Site City & State*
Date & Time of Exam*

MonthDayYear
DateHourMinutesAM/PM Option
Type of Examination administered:*

CASLI Generalist Knowledge ExamCase Studies ExamDeaf Interpreter Performance ExamNIC Performance Exam
Candidate's Name*

First NameLast Name
Candidate's RID Number*
5 or 6 digit RID ID Number
Type of Incident (check all that apply)*

Technical Issues with CASLI Exam System computer and/or other devicesPower outage or other problem with facilityEnvironmental disturbance not caused by exam candidateDisturbance caused by an exam candidateTest Administrator / Proctor showed up late (or not at all) to exam appointmentExam candidate arrived late or is no show for scheduled exam appointmentVerification issues where candidate's name on CASLI account did not match candidate's IDAcceptable form of government issued photo ID was NOT providedFails to provide Exam (Proctor) Token number or invalid Exam (Proctor) Token numberUse of unauthorized materials / suspected cheatingExam stopped by test administrator/proctor or candidateCancellation of exam less than 3 days from scheduled exam appointmentOther
Describe of any incidents that occurred during scheduled exam appointment prior/during exam administration in full details and as clearly as possible. Include your action taken. *
Please attach any supplement documentation or screenshot of the issues that will help us with this situation.

Browse Files

Cancelof
Test Administrator / Proctor Signature*

Clear
If you have any questions or concerns, please contact CASLI at testing@casli.org or call us at 571-257-4761
Should be Empty: