REQUEST FOR CHANGE
OF FINAL EXAMINATION DATE
(Must complete three copies)
Name of student__________________________ Laker I.D: _______________________
Course name, number, and section ___________________________________________
Name of Instructor _______________________________
Date and hour when final exam is scheduled ____________________________________
Date and hour of proposed time for exam ______________________________________
Reason for request ________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Signature of student _______________________________________
Student, please turn this form into the instructor of the course for which you are seeking a change. The form is due a week prior to the start of finals weeks.
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APPROVALS:
Date
_______________________ Instructor
________________________________________
Date
_______________________ Head of Dept.
____________________________________
Date ________________________ Dean of
School____________________________________
DISAPPROVED:
Date _______________________ Head of Dept ________________________________
Reason for disapproval: ____________________________________________________
________________________________________________________________________