Final Exam Retake Request
Find information
online:
www.ttuisd.ttu.edu
Questions? Call:
800.MY.COURSE
(800.692.6877)
Mail to:
TTUISD
Box 42191
Lubbock, Texas 79409-2191
806.742.7101
Locally
Fax to:
806.742.7222
806.742.7288
Full-time
diploma students
PLEASE NOTE:
•
If you are enrolled in a public or private school, it is your responsibility to receive permission from your school before
taking a re-exam. Some schools will not accept re-exams, and failure to receive prior approval could result in your
school not accepting the grade.
•
You must follow TTUISD’s exam procedures (the same procedures you followed when taking your initial exam).
•
If you change your proctor after this request is processed, there will be a $25 proctor change fee.
•
Send requests at least 30 days prior to your deadline date (ex: graduation date, course expiration date) All lessons
must be completed. Please note that it takes 3-5 business days to ship final exams for print courses. If your request is
received less than 30 days before your deadline, you may be subject to an overnight shipping fee.
Date ______________________ Student’s Name_______________________________________________________________________________
Social Security # or matriculation #*________________________________________________________________________________________
Address__________________________________________________________________________________________________________________
City___________________________________________________________ State______________________ Zip____________________________
Student Phone (______)______________________ Parent Phone (______) ________________________ Ext.____________________________
E-mail Address___________________________________________________________________________________________________________
Course Name __________________________________________________
Instructor’s Name: ______________________________________________
q
q
PRINT COURSES ONLY
Affix the “EX” bar TTUISD label here.
$
50 Exam Retake Fee
Do NOT use bar codes from other courses.
$
30 Overnight Delivery Fee - for paper exams only
Course Extension Fee - Your course expires on __________________.
If you do/did not complete your final exam retake by this date, you will need to extend your course. Extensions are non-transferable.
q Short Term $30 (non-refundable) - Extends for one (1) month
q Long Term $60 (non-refundable) - Extends for up to six (6) months
Total Fees: ___________________
PROCTOR INFORMATION
Proctor’s Name _________________________________________________
Title_____________________________________________________
Institution _______________________________________________________________________ E-mail__________________________________
Institution Address _______________________________________________________________________________________________________
City___________________________________________________________ State______________________ Zip____________________________
Phone (_______) _________________________________ Ext. _________ Preferred Exam Date ______________________________________
Reminder: If you change your proctor after this request is processed, there will be a $25 proctor change fee.
PAYMENT INFORMATION
q C heck – No temporary checks accepted (make checks payable to Texas Tech University)
CK#____________________ *Driver’s License #____________________ *Date of Birth___________________________________________
q
q
Money Order # (payable to Texas Tech University)_________________________________________________________________________
Credit Card:
q MasterCard q VISA q Discover q American Express
Card # _______________________________________________________ Cardholder’s Name _______________________________________
Expiration Date _______________________________________________ Signature _______________________________________________
*Required when paying by check
SEPT2015