Application for Deferred Exam

Required Field
Name Student #
Phone # Email

I would like to write a Deferred Examination(s) in the following course(s)(One Minimum):

Course Number and NameExam Date

Reason for applying to write Deferred Examination(s). (Please supply documentation)

Access to Information and Protection of Privacy - The information on this form is collected under the authority of the Memorial University Act (RSNL 1990 Chapter M-7) and is needed for and will be used to update your student record. If you have any questions about the collection and use of this information contact the Registrar, 709-778-0497.