Services to Students with Disabilities
Green Exam Notification Form

One form for each exam

Please complete the following:

Student Information
Student Name:
Student E-mail:
Student Phone:

Please check (?) one of the following:

Quiz/Unit test
Midterm
Final

Campus:

City Centre Campus
South Campus
Centre for the Arts
Alberta College

Course:
Section Number:
Instructor's Name:
Exam Date: mm/dd/yyy
Time Class Writes Exam:
Time You Write Exam:

When selecting your exam start and end time, consider the following:

  • You are writing the exam at a time that overlaps with the class time.
  • If approved for extra time, you don’t have a schedule conflict (e.g. missing another class)
  • You will be finished the exam no later than 9:00 p.m. (Monday – Thursday) or 4:30 p.m. on Friday

 

Protection of Privacy - This personal information requested on this form is collected and protected under the authority of the Alberta Post-Secondary Learning Act (s.65) and the Alberta Freedom of Information and Protection of Privacy Act (part 2).It will be used for the purpose of confirming and managing students' disability related exam accommodations coordinated by Services to Students with Disabilities (SSD). This form will be placed on file in the office that manages exam accommodations and later stored in the student's SSD file.

Questions concerning the collection, use and disposal of this information should be directed to: Chair, Services to Students with Disabilities, Grant MacEwan University, 7-119A, 10700-104 Avenue, Edmonton AB T5J 4S2