|TEST TAKER INFORMATION
|TEST TAKER ADDRESS AND PHONE NUMBER
|PLEASE DESCRIBE THE REASON FOR YOUR REQUEST
Statement of the nature of the circumstance:
PLEASE DESCRIBE THE EVIDENCE THAT YOU ARE PROVIDING
FOR YOUR CLAIM
A clear and concise description of documentation or references provided:
MS Word document, PDF, and graphic files are acceptable.
- Documentation providing evidence of the exceptional circumstance (such as a doctor’s note – please make sure license # is included; next of kin death notice; letter from official; flight cancellation notice, etc.)
- Supporting documentation from a healthcare or counselling professional which indicates a diagnosis of mental health or physical illness that prevents the test taker from completing the test (healthcare or counselling professional must provide license # in documentation).