Northwestern Athletics
Academic Services & Student Development

Student-Athlete Traveling Exam Request Form
Each student-athlete is responsible for completing the Traveling Exam Request Form for any class in which you were not able to schedule an exam or quiz make-up. This form should also be used when missing class due to athletically related injuries and/or surgical procedures.
You must complete this form at LEAST ONE WEEK prior to your departure from campus. Remember, each student-athlete is responsible for following up with the professor and making up any other missed work.

Today's Date:

Student Name (First and Last):
Student Sport:
Best Phone Number To Reach You:
Student Email:
Destination / Event:
Depart From Campus on:
Include Date AND Time:
Return to Campus on:
Include Date AND Time:

WHAT CLASS REQUIRMENT/S ARE YOU MISSING?

Please list the class(es) for these missed requirements, any arrangements you have made, and if you need our office to contact the professor to confirm a traveling exam/quiz:

(e.g.: I am missing a HIST 3XX exam. I have talked with the prof, he is willing to travel the exam, and is waiting for your follow-up e-mail with the arrangements.)

TO WHOM LETTERS/EMAILS SHOULD BE SENT:

Class #1

  1. Department/Class #/Day/Time:
    (Example: PSYCH 110 Tu/Th 10:30am-12pm)
  2. Prof./T.A./Name & Email:
    (EX: Professor Jones, p-jones@northwestern.edu/T.A. Smith, t-smith@northwestern.edu)

Class #2

  1. Department/Class #/Day/Time:
    (Example: PSYCH 110 Tu/Th 10:30am-12pm)
  2. Prof./T.A./Name & Email:
    (EX: Professor Jones, p-jones@northwestern.edu/T.A. Smith, t-smith@northwestern.edu)

Class #3

  1. Department/Class #/Day/Time:
    (Example: PSYCH 110 Tu/Th 10:30am-12pm)
  2. Prof./T.A./Name & Email:
    (EX: Professor Jones, p-jones@northwestern.edu/T.A. Smith, t-smith@northwestern.edu)

Class #4

  1. Department/Class #/Day/Time:
    (Example: PSYCH 110 Tu/Th 10:30am-12pm)
  2. Prof./T.A./Name & Email:
    (EX: Professor Jones, p-jones@northwestern.edu/T.A. Smith, t-smith@northwestern.edu)
 
Press to send your form or press to clear your form.

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