Student Adjustment Application Form
Submit your request for academic adjustment. Please provide accurate and complete information to help us process your application efficiently.
Full Name
*
First Name
Last Name
Student ID Number
*
Email Address
*
example@example.com
Academic Program / Major
*
Course(s) Affected
*
Type of Adjustment Requested
*
Please Select
Deadline Extension
Assessment Rescheduling
Attendance Accommodation
Alternative Assessment
Other
Reason for Adjustment Request
*
Please describe your requested adjustment
*
Supporting Documentation (if applicable)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Preferred Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Submit Application
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