Administrator / Proctor Renewal Application This process will take approximately 15-20 minutes and needs to be completed in one sitting. To renew your Administrator Status with National Registry, complete the following: Read the Test Administrator/Proctor Manual Read the instructions on how to enroll for Test Administrator/Proctor Training Course Complete the online Test Administrator/Proctor Training Course Read, sign, and submit the Test Administrator/Proctor Agreement Form (a copy of government issued identification must be included). Read, sign, and submit the Test Administrator/Proctor Code of Conduct Form Complete the Test Administrator/Proctor Account Update Information Agreements I have agreed to serve as a Test Administrator/Proctor for National Registry of Food Safety Professionals'(National Registry) Food Safety Manager Certification Examination (Exam) and the International Certified Food Safety Manager Examination, hereafter referred to as the FSMCE and ICFSM. I have read the Test Administrator/Proctor Manual (Manual), and will strictly adhere to all standards of administration, confidentiality, and all procedures and instructions including the Code of Conduct as specified in the Manual. I will not sit for the FSMCE or ICFSM within a period of one year before serving as a Test Administrator/Proctor for the Exam, except at a Pearson VUE exam center (preapproval from National Registry required) I am submitting professional references from three individuals which I have known for more than one year. I understand that I can only serve as Test Administrator/Proctor for the first 35 examinees. Beyond that number there must be one Test Administrator/Proctor for every 35 examinees and I must return a signed Test Administrator/Proctor Agreement for each Test Administrator/Proctor. I will locate, select, train, and supervise all Test Administrator/Proctors, Readers and Translators. I agree that immediately upon receiving exam booklets, I will verify the shipment and notate on the Test Administrator/Proctor Inventory Form. I agree to keep the Exams under double-lock in secure storage or in my sole possession until administration. I agree to maintain the security of the Exams before, during, and after the Exam administration. I agree that I will not provide the Exam or copies thereof to anyone other than an authorized representative of National Registry. I agree that I will not share any credentials including logins, passwords or any identification provided by National Registry. I agree to comply with the procedures for handling and breach of security as outlined in the Manual. I will organize and administer all Exam site activities and procedures, including securing a site that conforms to the requirements specified in the Manual. I will accurately check examinees' government issued photo identification. I will not offer any hints, suggestions, definitions, or clues to the answer of an Exam item. If there are questions as to the understanding of an Exam item, I will provide the examinee with an Examinee Comment Form. I will ensure no talking or communication of any form between examinees occurs during the Exam. I will ensure all of the examinees' books and class materials are stored at the front or back of the room. Under no circumstances will I examine or discuss the Exam contents with the examinees before, during, or after the exam. I will ensure that no Exam materials leave the room with the examinees or have been photocopied. I understand that a representative of the National Registry may audit any administration of the FSMCE and ICFSM. I affirm that I am not an employee of any other ANSI/CFP accredited FSMCE and ICFSM organization. I understand that I cannot reproduce certificates or wallet cards, alter certificates or wallet cards, or otherwise misrepresent the information contained on the original document. I agree to take the Test Administrator/Proctor training course and non-disclosure every 3 years. I agree that the confidentiality and non-disclosure requirements set forth herein survive the expiration or termination of this Agreement. I hereby affirm that my responsibilities as a Test Administrator/Proctor are critical for a fair and equitable administration of the National Registry of Food Safety Professionals' Food Safety Manager Certification Examination Program to each examinee and that the Exam and its contents are intellectual property owned by National Registry. Confidentiality, Nondisclosure and Conflict of Interest: I may be afforded access to proprietary information, confidential documents, and Exam materials, and I hereby agree that I shall not disclose or provide to any person or entity, directly or indirectly, any information or pertaining to the preparation, Exam, and/or grading services provided by National Registry. I agree not to participate in any activity, either as a volunteer or for pay, in which there may be a conflict of interest with activities related to the National Registry examination programs and agree to bring potential or actual conflicts of Interest to the attention of National Registry. I agree that I will not examine any of the Exam materials, unseal any sealed Exam booklets, or divulge any Exam content with examinees before, during, or after the Examination. It is understood that all documents, Exam questions, or confidential information received from National Registry are and shall remain the exclusive property of National Registry, and that all documents or information shall be returned promptly to National Registry. Controlling Law/Venue: The validity, interpretation, and performance of this Agreement shall be controlled by and construed under the internal laws of the State of Florida, without regard to conflict of law principles. This Agreement shall not be construed for or against either party. Venue for any legal proceeding or action at law arising out of or construing this Agreement shall lie solely and exclusively in the state courts of Orange County, Florida, or the United States District Court for the Middle District of Florida, Orlando Division. Both parties acknowledge that this Agreement was created in and will be partially performed in the State of Florida, and therefore, each party agrees to submit to the exclusive personal jurisdiction of the State of Florida for a resolution of all disputes arising in connection with the interpretation, construction or enforcement of this Agreement, and each party hereby waives any claim or defense to such courts, including any claim or defense that such courts constitute an inconvenient forum. Attorney's Fees: If either party initiates or is made a party to legal proceedings in connection with this Agreement, then the non-prevailing party in those proceedings will pay the costs and reasonable attorneys' fees of the prevailing party. Severability: Legal unenforceability of a single provision in this Agreement shall not prevent enforcement of any other provisions of this Agreement. Contract Breach: Any breach of this Agreement, including inappropriate conduct such as lying or cheating while participating in an Exam which shall be deemed a material breach, shall permit National Registry to pursue all available legal remedies, including seeking monetary damages and injunctive relief in addition to resulting in future exclusion from any and all National Registry certification designations, examinations, and other programs. I understand that should I fail to follow the standards set forth by the National Registry, or the procedures provided in the Manual, my privilege as a Test Administrator/Proctor will be revoked and that National Registry shall have the right to announce and publish such revocation in whatever form and location(s) as National Registry deems appropriate in its sole discretion and in order to protect the public. New Accounts: I agree to abide by and adhere to all financial requirements as presented on the Account Billing Form. Code of Conduct I understand that my personal standards of honor and integrity must, at all times, be above reproach and I must conduct myself in a manner that reflects favorably on my profession. By doing so, I will strive to create an ethical climate within my organization, my industry and the community of clients which I serve; building honesty and trustworthiness in all relationships and ensuring reliability in performing my assigned responsibilities. I agree to: Be truthful and accurate in what I say, do, and write. Adhere to the law at all times. Promote and encourage the highest level of food safety within the industry. Not misrepresent nor permit misrepresentation of my qualifications or the qualifications of my associates. Maintain due regard for the environment and for the public safety, health, and well-being. Strive to maintain competence by remaining current with changes in the industry. Understand the certificate, logo, and marks for the FSMCE/ICFSM are the intellectual property of National Registry; and I will use such property only in a manner approved by National Registry. Uphold and follow all policies and procedures required by National Registry to remain in good standing. Report to National Registry any pending litigation and resulting resolution related to my work in food safety. Avoid any interest, activity, or influence which may be intended to influence a decision purely for personal gain and not in the interest of public safety. Additional Information Have you ever been an administrator for an ANSI/CFP accredited provider (ServSafe, Prometrics, State Food Safety, etc.)?*YesNo If so, have your privileges ever been revoked?*YesNo If yes, please explain: Do you have a relative that is a Test Administrator/Proctor for NRFSP?*YesNo If yes, who?: Test Administrator/Proctor Account Update If you need to update your account information, please enter the information below: If your name has changed, please attach one of the following documents: Legal name change Divorce decree Marriage license File Types: jpg. pdf. (limit 3MB) If you need to add or remove a company from your existing account, please download the Account Billing Form and fax it to 407-352-3603 or email it to customer.service@nrfsp.com. eSignature*