Test Retake Request
Name:
Period:
Test:
Score:
Requirements for retake:
 Score must be below 90%.
 Study guide must be completed and
attached to this form.
 You must study
Explain why you scored lower than expected
and why you want to retake the test:
Student Signature:
Parent Signature:
Your request for retake
has been:
____ Approved
____ Denied
Your retake is scheduled for:
Date:
Room:
Time:
Note: If you need to reschedule this
appointment, email (add your email).
Failure to show for a scheduled meeting
without prior contact mean this contract is
null and void. Set up a reminder in your
phone.