AFTER EXAMINATION BREAKDOWN REQUEST
For Failed Exams Only
(Must be requested 30 days from Register Date and may take up to 90 days to receive)
EMAIL REQUESTS TO: recruiting@brla.gov
SSN: _____________________________________________ Applicant PIN Number: ________________
First Name: ____________________________________ MI.: Last Name: _______________________________
Email Address: _______________________________________________________________________________________________
Exam Title: ___________________________________________________________________________________________________
Exam Date: _______________________________
To Be Completed By HR Only:
Exam Register Date: ____________________________ Date of Request: _______________________________________
Completed By: _______________________________________________________________________________________________