Testing Center
Make-Up Test Request Form
One week advance notice is required for arranging accommodations for a make-up test date. Make-up tests are not administered during final exam week.
STUDENT INFORMATION
Home Phone Number Cell Phone Number Email Address
First Name Last Name Banner ID Number
TEST INFORMATION
Course Title Instructor Name
Date of Test Time Day of Week
Date of Make-Up Test Time Day of Week
SERVICES NEEDED
Please complete all that apply.
Access to computer and printer (please describe):
Other (please describe):
Has your instructor approved of this alternate exam time and are they aware that the exam needs to be dropped off one day prior to the exam date?
n
Yes
n
No
COMPLETED BY
Student Signature Date
December 2018/PR