CSC 238H -- REQUEST FOR SPECIAL CONSIDERATION
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 Student number: ___________________ 


 Last name:      ___________________


 First name:     ___________________


 Email address:  ___________________


 Assignment/Test number: ___________    Date of request: ___________________


Reasons for request (be concise and clear, use the reverse if needed, and
submit supporting documentation stapled together with this form to your
instructor):





















                                  Signature ________________________________

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DO NOT WRITE BELOW THIS LINE
Space for instructor's recommendation: