EASTERN GATEWAY COMMUNITY COLLEGE

Proficiency Exam
Procedure:
Students desiring to take a proficiency examination must first consult with their advisor
and or instructor who may be administering the examination. After the consultation, the student
must receive written approval on this form from the appropriate department dean prior to taking
the examination. Upon approval, the student must pay the $30.00 fee to the Business Office
cashier. You may contact the Business Office at 740-264-5591 ext. 1625. The student will then
return the form to the examiner. The examiner will record the date and result and submit the form
to the Department Dean for review. The Dean will make the recommendation to the Student
Information Center that the credits passed by examination become a part of the student’s
permanent record. If the examiner is entitled to the proficiency examination rate, the form should
be routed to the Business Office who will forward the form to the Student Information Center. IF
test is not directly administered by an EGCC instructor or employee, the exam must be proctored
by a third party. Acceptable proctors include libraries, college/university, test centers, GED test
sites, or local schools (High School, Elementary School, Middle School). The student must make
arrangements for out of state proctoring. Then have proctor approved by EGCC. If questions
about acceptable proctoring facility, please contact 740-266-9631. When student has identified an
acceptable proctor, instructions will be sent to that proctor for the administration of the exam.
The student must be enrolled at Eastern Gateway Community College in order to take a
proficiency examination. A student is eligible to take a proficiency examination only once
per course. A student is not eligible to take a proficiency examination for a course
previously taken at EGCC. NOTE: A separate form must be completed for each
examination a student wishes to take.

NAME__Isabella Quinones______________________ STUDENT ID#_000174264______________

ADDRESS_8933 SW 123 Court apt 305 Miami Fl.33186

PHONE 813-5676293 ________________________________

I request permissions to take a proficiency test in:

COURSE NUMBER__________ COURSE TITLE_BIO 101______CREDITS 3_______

I submit the following evidence of previous unique training, background, or experience in the subject area
named above.

DATE OF REQUEST__02/18/2020____ STUDENT’S SIGNATURE__________________________

PERMISSION GRANTED__________ REQUEST DENIED____________ DATE____________

FACULTY SIGNATURE ____________________ DEAN SIGNATURE____________________

$30.00 fee for proficiency examination paid ____________________ DATE________________________
(Business Office)

RESULTS OF PROFICIENCY EXAMINATION

HAS PASSED __________ HAS FAILED__________

the proficiency examination given on _____________________ at __________A.M. P.M.

SIGNATURE OF THE EXAMINER_____________________________________________________

NOTICE TO PAYROLL
__________________________ has administered the above proficiency examination outside his/her
approved workweek and is entitled to the proficiency examination rate of $10.00

___________________________________ PROFICIENCY
(DEPARTMENT DEAN) RATE PAID
___________________________________
(DATE)
(BUSINESS
OFFICE)
(DATE)