IL Exam Request at the DL Testing Center

• Before filling out and submitting this form, please make sure you submitted all assignments prior to the exam. If you have any questions concerning your exam contact the Office of Independent Learning, (270) 745-4158.
• Use this form ONLY if you want to take your exam at the WKU DL Testing Centers at Western Kentucky University, Main Campus: 108 Garrett Conference Center or South Campus: C240.
• For requests to take exams OFF CAMPUS, please use the off-campus exam request form.
• Items noted with an *asterisk are required.

IMPORTANT: You must present a valid photo ID at the testing center before being allowed to take your exam.

Testing Center Location

*Which testing center location will you be taking your exam at?	Garrett Conference Center South Campus Testing Center

Exam Information

Today’s Date
*Exam Number or Name (e.g. Exam 1, Midterm)
*DATE Examination is Wanted
*TIME Examination is Wanted
*Course ID Number (e.g. ENG 100)
*Course Title
*Course Instructor

Your Contact Information

*Your name
*Street address
*City
*State
*Zip Code
*Your email address
*Your phone number

Student Information

*Are you graduating this semester?	Yes No
*Are you receiving financial aid this semester?	Yes No

Confirmation

I have completed all applicable assignments/lessons that are necessary to take this exam. (NOTE: the form cannot be submitted unless this box is checked.)