A Request Form for 001101 Make Up Exams and Tests

Written at ____________________
Day_________ Month_________________ Year___________

Subject: Request to take a make-up exam for 001101 course

To: 001101 Course coordinator
I am ______________________________ student code ______________ would like to request to take a
make-up exam for 001101 course
___Listening test ___Speaking test ___Final exam
___Writing test ___Midterm exam ___Others…………
because
_______________________________________________________________________________________
_______________________________________________________________________________________
I have attached the evidence for my absence which are

1…………………………………………………………………………………………………………
2…………………………………………………………………………………………………………
3…………………………………………………………………………………………………………
This semester I have enrolled for 001101 section number_____________ and the instructor’s name is
________________________________.
Thank you for your consideration.
Please contact me at (phone no.) _________________ Home phone no./parent’s no.____________________

Sincerely yours,

Student’s signature_________________________________

Advisor Course Coordinator

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(Sign)………………………………………….. (Sign)……………………………………….

Date…………../..................../............ Date............../................./............

The reasons for the make-up exams/tests must follow these cases:
1. Students are sick and have a document from a hospital/doctor as a proof.
2. Students attend a seminar or a training and have a document from a host as a proof.
3. Students attended military training service and have a document as a proof.
4. Unexpected circumstances/accidents such as death of family member or accidents, and have a
document as a proof.