Assignment Request

If you have missed a Midterm Test, a Final Exam or Assignment, you must complete this form. Your make-up test or make-up exam will not be scheduled if the form is not complete and submitted within 48 hours of the missed component.

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 Name *
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.