Exam Variance Request Form v5.25 Date First name * Last name * Email * Student ID * Semester * E.g. Fall 2025 Course Code * E.g. LAW 1000 B1 Course Title * Instructor Name Assessment type * Quiz Exam Final exam Is this a recurring quiz? * Yes No Assessment date * For self-scheduled assessments (e.g., a quiz that is open for one week), please input the day the assessment opens. If the open date has already passed, please use the date you intend to take the assessment. What is the name of the quiz/exam? * Ex. “Week 3 Quiz” or “IRAC Test Questions” Will the assessment be administered on campus? * Yes No What time is your class scheduled to take this quiz/exam? [NOTE: if you need to return to class after your quiz/exam by a specific time, please calculate the time you will need to start your quiz/exam before class and input that time here.] * 121234567891011 : 00153045 AMPM Is this quiz/exam scheduled during prep week or capstone? * Prep week Capstone No Recurring quiz information Quiz date * For self-scheduled assessments (e.g., a quiz that is open for one week), please input the day the assessment opens. If the open date has already passed, please use the date you intend to take the assessment. Quiz title * Ex. “Week 3 Quiz” or “IRAC Test Questions” Will the assessment be administered on campus? * Yes No What time is your class scheduled to take this quiz/exam? [NOTE: if you need to return to class after your quiz/exam by a specific time, please calculate the time you will need to start your quiz/exam before class and input that time here.] * 121234567891011 : 00153045 AMPM plus1 Add next recurring quiz date minus1 Remove Are there specific details about your quiz or exam that Student Services should be aware of? Variance information * Extraordinary circumstances ESL (English as a Second Language) accommodations Religious holiday Exam conflict The Dean of Students will reschedule exams only under extraordinary circumstances. Examples of such circumstances may include: The student’s illness or injury, or an illness, injury, or death in the student’s immediate family, which prevents the student from taking an exam. The time of an exam conflicts with the student’s religious belief or practice. A student has two scheduled final exams that are scheduled to begin within 23 hours of each other (e.g., a 6:00 p.m. scheduled final exam on a Monday followed by a 5:00 p.m. scheduled final exam the next day would be a conflict; however, a 6:00 p.m. scheduled final exam on a Monday followed by a 6:00 p.m. scheduled final exam the next day would NOT be a conflict). Note: This 23-hour rule applies only to scheduled final exams, not to self-scheduled or take-home final exams, and not to any in-session exams. A student has three scheduled final exams scheduled within a period of 3 calendar days, in which case a student may reschedule one scheduled final exam. Note: This 3-day rule applies only to scheduled final exams, not to self-scheduled or take-home final exams, and not to any in-session exams. Unanticipated event that conflicts with an exam; such event must be one that requires the student to attend (note: this exception is rare; events such as travel/vacation plans, weddings, employment obligations, etc., do not qualify). Exam rescheduling is coordinated in Student Services, Room 119. Specific make-up dates for final exam conflicts are scheduled at set times during the final examination period. Students must take rescheduled final examinations on the next available makeup date that does not cause a new conflict in the student’s final exam schedule. No make-up exam will be rescheduled more than two weeks after the end of the regular final exam period. Students who are unable to complete any exam within this time frame will be withdrawn from the course(s) unless the Dean of Students grants an exception for extraordinary circumstances. MHSL Academic rule 1.04 D. 1 Describe the extraordinary circumstances * Email documentation evidencing the circumstances to the Dean of Students [email protected]. State the religious holiday for which you need an accommodation * Email documentation evidencing your religious affinity to the Dean of Students [email protected] State the exams for which you have a conflict * List your ENTIRE exam schedule here. If you are human, leave this field blank. Submit