Make-Up Request Form Fall 2017
Please follow the instructions below when a student misses an exam. Please do not administer your own make-up exam.

1. Email the names of absentees to Shulamith at biderman@yuhsg.org as soon as an exam is missed.
2. Complete this form on the day of the missed exam.
3. Label the make-up exam and any accompanying materials with each student's name.
4. Put the exams/materials in a manilla envelope available in the office.
5. Label the manilla envelope with your name and course name.
6. Place the envelope in Michal's mailbox (not on her library desk). Envelopes can be found on the wall next to Michal's box.
7. Make-ups exams will be administered and returned to your mailbox.

Email address
Teacher's Name
Your answer
Date of the missed exam
MM
/
DD
/
YYYY
Course Name
Your answer
Grade
Student Name
Your answer
Student Name
Your answer
Student Name
Your answer
Student Name
Your answer
Student Name
Your answer
If you are aware of extenuating circumstances, please describe here:
Your answer
A copy of your responses will be emailed to the address you provided.
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