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Special Exam Accommodations   


 

* Required Fields

 

I am applying for a Request for Special Exam Accommodation for the  semester and   term.

Last Name:*

First Name:*

Student ID Number:*

(Do not use ssn)

Division*

Address:*

State:*

City:*

Zip:*

SHU Email:*

EXAMINATIONS
** List all of your in-class examinations in date order. 

 

  Date**

Time

Course Number
(Ex: PUBG7801MM)

Course Name
(Ex:Administrative Law)

Professor

 

 

 

 

 

 

 

 

           

Reason for Special Accommodations

 


 

 

Other
Please list any specific technology or physical space modifications needed and/or include any other information you believe is necessary.