Conflict In Examination Form

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Conflict In Examinations
If you have two in-class exam that have starting times within 23 hours of each other (ex. 6 p.m. one day and 5 p.m. the following
day) or if you have three in-class exams in three calendar days then you should use this form to request an adjustment in your exam
schedule. Please note: All exams must be taken after the original date of the exam.
Date: ___________________________
Name: _________________________________________
ID #: ____________________
Phone Number: _________________________________
Exam #: __________________
Current Complete Exam Schedule:
Exam:
Instructor:
Exam Date:
Time:
__________________________________
____________________________
__________
___________
__________________________________
____________________________
__________
___________
__________________________________
____________________________
__________
___________
__________________________________
____________________________
__________
___________
__________________________________
____________________________
__________
___________
Requested Exam to be Rescheduled:
Exam:
Instructor:
__________________________________
____________________________
You will receive an email from Student Services instructing you of your new exam date and time.
Office use only
Exam Make-up Schedule
Date of Exam: _________ Time of Exam: _________ Length of Exam: __________ Exam Room: __________
________________________________________________
Assistant to the Dean of Students
Note: Students taking rescheduled examinations should be advised that all possible steps are taken by the Student
Services Office to preserve anonymity for grading purposes.
Please return your completed form to the Student Services Office, Room 119.
Last updated December, 2015
mitchellhamline.edu

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