Makeup Exam Request

Rockford.edu / Academics / Center for Learning Strategies / Makeup Exam Request

Student Makeup Exam Form

Please read and acknowledge the instructions for requesting an exam carefully before submission.
Requests must be submitted for dates at least five (5) calendar business days after the form submission date.
All makeup exams must have the approval of the course instructor. Requests should indicate at least three (3) separate time preferences as scheduling options.
Clearly indicate first and last name, course name and number, and a working contact phone number for proper request processing.
CLS adheres to the Rockford University Academic Integrity Policy which applies to plagiarism, cheating, and the academic regulations of Computer Labs and Library services. A complete reading of the Academic Integrity Policy may be viewed by following the link provided. View the Academic Integrity Policy
Please review the 7 Simple Rules for Test Success in CLS.
Notifications will be forwarded exclusively to Rockford University email accounts. The faculty of record for courses listed on the student request form will be copied on student test scheduling confirmation email.

_____________________________________________________________________________________________________________

_____________________________________________________________________________________________________________

Makeup Exam Request Form

"*" indicates required fields

Name*

First Last

Email*

Phone*

Student ID #*

Professor's Name*

First Last

Course Name and Number*

Exam Date on Syllabus*

Do you have an accommodation profile with Lang Health?*

Yes

Test Date Availability Option 1 Request*

*Note: Date(s) requests need to be no less than 5 days after the date of this request.

Time Option 1*

Time Option 2

Test Date Availability Option 2 Request*

*Note: Date(s) requests need to be no less than 5 days after the date of this request.

Time Option 1*

Time Option 2

Additional comments or questions: