Exam Rescheduling Request Form

Please don't fill out this input box.

First Name:*

Last Name:*

Date:*

Student ID:*

Semester:

Phone Number:

Email:*

Note: Please be sure to include a copy of your course schedule along with this form.

Number of Exams to Reschedule:*

Name of Course(s) and Date(s) of Exam(s):*

Reason for Request:*

Note: Please be aware that your request isn't complete until you've received a response from the Office of Student Affairs.

Student's Electronic Signature*

Today's Date*