Indiana University-Purdue University Indianapolis
The Testing Center
   
The Testing Center
 
 
 

Retest Administration Request

This form must be filled out entirely, and can only be requested by an IUPUI Staff / Faculty Member with student counseling or admissions privileges. Forms filled out by students or otherwise will be discarded without notification. The request will be verified for both appropriateness of the retest as well as for identity of the submitter.

This form is for IUPUI Staff / Faculty use only.

Student's Name

Student's Identification #

Name Of Test To Be Administered

Faculty / Staff Name (Your Name Here)

Submitter's Email Address

Department

Address

Phone

Justification for Retesting