Exam accommodation request form

Before you begin to fill in this form, make sure you have:

student ID number
course title, course code, instructor, and exam date and time for each exam for which an accommodation is being requested

Any supporting documentation should be submitted by email to assocregistrar@mta.ca.

* Indicates required field

Please confirm if an exam accommodation may be granted for your particular exceptional circumstances prior to submitting this form.

Full name *

��Ƶ Allison student ID *

��Ƶ Allison e-mail *

Accommodations requested

I am applying for accommodation for the following exam(s)

Re-order	Course title	Course code	Instructor name	Exam date and time	Weight	Operations
	Course title	Course code	Instructor name	Exam date and time	Item weight

more items

Click on the "Add" button to include additional exams

Student illness

Death or funeral

Medical issues

Car accident/breakdown

Weather issues

Religious grounds

Compassionate

Other reason

Additional details

Yes

I understand that misrepresentation of an illness or circumstances constitutes academic dishonesty *

Circumstances are listed on the exam information page.

Yes

More than once

Yes

By submitting this form, I acknowledge having read and understood the information detailed on this form. *

CAPTCHA