Fillable Academic Counselling, Science and Basic Medical Sciences | (Brescia University College)

Fill Online, Printable, Fillable, Blank Academic Counselling, Science and Basic Medical Sciences | (Brescia University College) Form

Use Fill to complete blank online BRESCIA UNIVERSITY COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Academic Counselling, Science and Basic Medical Sciences | (Brescia University College)

On average this form takes 16 minutes to complete

The Academic Counselling, Science and Basic Medical Sciences | (Brescia University College) form is 1 page long and contains:

  • 2 signatures
  • 51 check-boxes
  • 34 other fields

Country of origin: CANADA
File type: PDF

Canada forms for Brescia University College

BROWSE BRESCIA UNIVERSITY COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
ACADEMIC CONSIDERATION
REQUEST FORM
Academic Counselling, Science and Basic Medical Sciences | NCB 280 www.uwo.ca/sci/counselling | submit to: https://help.sci.uwo.ca/servicedesk/customer/portal/3
For ACADEMIC COUNSELLING OFFICE USE ONLY:
Record Checked:
SAS Form Given:
SPC Exam Form Given:
Denied:
By:
Additional Doc in LF?
Department/Student Notified (initial):
Date Notified:
NOTES:
V10 06/013/18
NOTE: Medical Documentation must be submitted within 2 business days of end of illness as indicated by the doctor/health care professional
Section #3: Course Components Affected by Absence
DATE:
TIME:
Course Name & Number
(ex. Biology 1001a–001)
Course Component
Exam/Midterm
Conflicts Only:
CONFLICTS: Please indicate in far right column what you will be rescheduling. Please check makeup times before submitting this form.
Class
Lab
Tutorial
Assignment
Test/Quiz
Midterm
Midterm (in class)
Midterm (Special)
Final Exam
Final (Special)
Class
Lab
Tutorial
Assignment
Test/Quiz
Midterm
Midterm (in class)
Midterm (Special)
Final Exam
Final (Special)
Class
Lab
Tutorial
Assignment
Test/Quiz
Midterm
Midterm (in class)
Midterm (Special)
Final Exam
Final (Special)
Class
Lab
Tutorial
Assignment
Test/Quiz
Midterm
Midterm (in class)
Midterm (Special)
Final Exam
Final (Special)
PLEASE READ: I confirm that the information provided is complete & accurate. I understand that it is my responsibility to inform my professors as well as the Dean’s
Office about absences in a timely manner so that appropriate arrangements can be made.
Exam/Midterm Conflicts: By signing below, I confirm that the makeup to the exam/midterm I have chosen to defer does not conflict with another exam/midterm,
lab, tutorial or class.
I write with Accommodated Exams (Student Accessibility Services (SAS)): YES NO
Student Signature: _____________________________ Date: ________________________
Section #1: Student Information
Student #:
Date:
First Name:
Last Name:
Western
EMAIL:
Phone:
Section #2: Reason for Consideration/Documentation Provided
REASON:
Compassionate
Varsity
Medical/Mental Health  Other_______________
Midterm Conflict
Religious Holiday/Holy Day
DOCUMENTATION PROVIDED:
Student Medical Certificate or Other Type of Medical Note
Intercollegiate Athletics Commitment Verification Form
Other (provide details): ________________
click to sign
signature
click to edit
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Academic Counselling, Science and Basic Medical Sciences (Brescia University College)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 9 May 2022

Message

View Audit Log
Print With Audit Log
Duplicate Document