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| {{#Wiki_filter:ES-201 Examination Security Aqreement Form ES-201-3 | | {{#Wiki_filter:}} |
| : 1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examnations scheduled for the week(s) of Auoust 2017 as of the date of my sígnature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as specifically noted below and authorized by the NRC (e.9., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide dírect or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations and/or an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
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| : 2. Post-Examination To the besi of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of Auqust 2017. From the date that I entered into this security agreement until the completion of examination administration, I did not instruct, evaluate, or provide performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authored by the NRC.
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| PRINTED NAME JOB TITLE / RESPONSIBILITY DATE SIGNATURE (2) DATE NOTE t'br,*{ol /o.r*ns froa Lpr'd tu
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| 8/rclz
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| 11 1
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| 13.
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| 1 15.
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| NOTES:
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| ES-z01 Eiamination Security Ag reement Form ES-201-3
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| : 1. Pre-Examination I acknowledge that I have acquired specialized knowledge about the NRC licensing examinations scheduled for the week(s) of Auqust 2017 as of the date of my signature. I agree that I will not knowingly divulge any information about these examinations to any persons who have not been authorized by the NRC chief examiner. I understand that I am not to instruct, evaluate, or provide performance feedback to those applicants scheduled to be administered these licensing examinations from this date until completion of examination administration, except as speciftcally noted below and authorized by the NRC (e.g., acting as a simulator booth operator or communicator is acceptable if the individual does not select the training content or provide direct or indirect feedback). Furthermore, I am aware of the physical security measures and requirements (as documented in the facility licensee's procedures) and understand that violation of the conditions of this agreement may result in cancellation of the examinations andlor an enforcement action against me or the facility licensee. I will immediately report to facility management or the NRC chief examiner any indications or suggestions that examination security may have been compromised.
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| : 2. Post-Examination To the best of my knowledge, I did not divulge to any unauthorized persons any information concerning the NRC licensing examinations administered during the week(s) of Auqust 2017. From the date that I entered into this security agreement until the completion of examination admínistration, I did not instruit, evaluate, or proüe performance feedback to those applicants who were administered these licensing examinations, except as specifically noted below and authorized by ihe NRC.
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| PRINTED NAME JOB TITLE / RESPONSIBILITY STGNATURE (1) DATE SIGNATURE (2) DATE NOTE 1
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| ..Lo^tt?. '¿"éo Lot l¿no ? 5/ølz J.
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| 4.
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| c o.
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| 7 B
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| I 10.
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| 11 12 13.
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| 14 NOTES;}}
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