Application to retake/redo a grade

Name: ____________________________________________________________________________
Title of Assignment/Assessment: _______________________________________________________
Original grade: ___________

STAPLE your original test or answer sheet to this page after making corrections.

I believe I got this poor grade because _____________________________________________________

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My plan to study and improve my grade is _________________________________________________
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The date and time I will attend tutorials is:
Date: __________________

Time: _________________

Date of proposed retake: ___________

Student Signature: ________________________________________________________ date: ________

Parent Signature: _________________________________________________________ date: ________