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  • Special Exam Request Form: Faculty of Arts & Science

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    Students who are unable to write final exams due to illness or circumstances beyond their control may request a special exam by submitting this form to the Dean of Arts & Science within one week of the exam date, along with supporting documentation such as a medical certificate. The Dean's decision on special exams is final. There is normally a $60 fee for special exams, which can be waived in some cases. The form collects student information, course details, the reason for the special request, and requires signatures from the student and instructor.

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    Special Exam Request Form

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    Students who are unable to write final exams due to illness or circumstances beyond their control may request a special exam by submitting this form to the Dean of Arts & Science within one week of the exam date, along with supporting documentation such as a medical certificate. The Dean's decision on special exams is final. There is normally a $60 fee for special exams, which can be waived in some cases. The form collects student information, course details, the reason for the special request, and requires signatures from the student and instructor.

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    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    4 views2 pages

    Special Exam Request Form: Faculty of Arts & Science

    Uploaded by

    StarLink1
    Students who are unable to write final exams due to illness or circumstances beyond their control may request a special exam by submitting this form to the Dean of Arts & Science within one week of the exam date, along with supporting documentation such as a medical certificate. The Dean's decision on special exams is final. There is normally a $60 fee for special exams, which can be waived in some cases. The form collects student information, course details, the reason for the special request, and requires signatures from the student and instructor.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    FacultyofArts&Science

    SpecialExamRequestForm

    Students who are unable to write final examinations because of illness or other circumstances beyond their control, or
    whose performance on the examination has been impaired by such circumstances, may, on application, be granted
    permissiontowriteaspecialfinalexamination.Suchapplicationmust:

    1.
    bemadeinwritingtotheDeanofArts&Sciencenotlaterthanoneweekafterthedateoftheexamination;and

    2.
    befullysupported,inthecasesofillness,byamedicalcertificateorbyappropriatedocumentsinothercases.

    The Dean's decision on special final examinations is final and may not be appealed to the Student Academic Standing
    AppealsandPetitionsCommittee.

    Asstatedinthecalendar,thereisnormallyafeeforallspecialexaminations.Thisfeeis$60.00.

    StudentInformation(pleaseprint)
    StudentName

    StudentID

    HomePhone#

    CellPhone#

    Email

    Course/ExamInformation
    CourseCode
    Instructor

    CourseName
    OriginalExamDate,
    Time,andLocation

    AreyouregisteredwithStudentAccessibilityServicesandreceivingexamaccommodations?YESNO

    Isthisyourgraduatingyear?YESNO

    AreyouinConcurrentEducation?YESNO

    NOTE:SpecialexamsapprovedbytheDeanarescheduledtobewrittenaftertheexamperiod(ie.JanuaryorMay)

    ReasonforSpecialRequest:(Pleaseattachcopyofmedicalcertificateorotherappropriatedocuments)

    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________
    ____________________________________________________________________________________________________

    StudentSignature_____________________________________Date________________________________

    RECOMMENDATIONtobecompletedbycourseinstructor(requiredonlyincasesotherthanillnessorbereavement)
    ________________________________________________________________________________________________________________
    ________________________________________________________________________________________________________________
    ________________________________________________________________________________________________________________
    ________________________________________________________________________________________________________________

    InstructorSignature_________________________________Date________________________________

    OFFICEUSEONLY

    DEAN'SDECISION:

    DeansSignature_______________________________________

    Approved

    Denied

    ExamFee:
    Required
    Waived

    Comments:______________________________________________________________________

    Approvedspecialexam:

    Exam
    Date
    Time
    Room

    ProtectionofPrivacy:
    TheinformationonthisformiscollectedundertheauthorityoftheNipissingUniversityAct,1992.Itisrelateddirectlytoandneededbythe
    UniversitytosupportyourrequestforaSpecialExam.ThisinformationwillbeusedtodetermineyoureligibilityforaSpecialFinalExamandwillbe
    disclosedtoemployeesintheFacultyofArtsandScience.Ifyouhaveanyquestionsaboutthecollection,useanddisclosureofthisinformation
    pleasecontacttheFacultyofArtsandScienceOffice,NipissingUniversity,100CollegeDrive,NorthBay,ONP1B8L7.(705)4743450ext.4266

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