Requester Information
Please enter your full name
Please enter your position.
Course Information
Please select a campus/campuses for which the course was delivered.
Faculty/Department
Please enter the complete name of the course.
Please enter the alpha-numeric course code. (A course code is normally composed of a 4-letter subject and a 4-digit code. e.g. ANTH-1032)
Please enter the 2-digit or 3-digit section code.
Exemption
Please enter your Dean's full name.
Please enter your Dean's valid LU email address ending with @lakeheadu.ca so that your Dean may also receive a copy of this form submission. 
Please indicate how long the exam exemption should remain in place
Please upload a mock exam.
One file only.
5 MB limit.
Allowed types: pdf, doc, docx.
I hereby certify that the information provided is correct and that I have followed all procedures as outlined in the Senate Regulation on past examinations.
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