Assignment Request

If you have missed a Midterm Test, a Final Exam or Assignment, you must complete this form.

Student Name Student Name First Last
Student Number
Must be 9 digits. Currently Entered: 0 digits.
Student Email
Course Code
Course Section
Must be 1 characters. Currently Entered: 0 characters.
Component of the course missed
If Other, please specify

Please indicate the component of the course missed.
Date of Missed Test/Exam/Assignment Date of Missed Test/Exam/Assignment / MM / DD YYYY
Time of Missed Test/Exam Time of Missed Test/Exam : HH MM AM/PM
Please indicate the reason for missing the test/exam or assignment.

Please use the drop down menu to select the reason for the missed test.
If other, please specify
Please explain how this interfered with your ability to complete the test/exam/assignment by or on the specified date.

Briefly describe the reason for the missed test/exam.
You may attach any additional supporting documentation. (Optional)

Attach Files
Course Director's Email or Teaching Assistant's Email. Please follow procedures as per your course outline.

Please include your course director's email. Your request for will be sent to the course director's email.
Course Director's Name