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INSTITUTE OF GRADUATE STUDIES

SINGLE COURSE EXAMINATION REQUEST FORM
LEE F 15-1

I am currently enrolled in the Department of ………………….…………. /

……………………….. Program, with student number……………………

I would appreciate if you kindly accept my request to sit a single course examination for the
below mentioned course that I have taken in Academic Year 20…... / 20….. Fall/Spring Semester.

Below, indicate the reason why you wish to sit a Single Course Examination:

Raise my GPA ( )

Pass a failed exam ( )

Indicate the Course Code: ………………………………………………………….

. Student’s Name-Surname/ Signature

………………………………………

APPROVED
Academic Advisor
(Name-Surname / Signature)

Rev.00 Issue Date 14.09.2020 Revision Date: -