Off-Site Exam Request Form

  1. Please complete all Sections on this request form to write your exam at another post secondary institution. Be sure to read and follow the instructions on the Off Site exam information sheet.
  2. Students are required to submit this request form two weeks prior to the on-campus exam date in order for the exam arrangements to be processed on time. A separate request form is required for every exam.
  3. Please confirm with your instructor the format (e.g. multiple choice, case study, etc.) of any exam that is not scheduled to coincide with the on-campus exam (Toronto time) as the format may not be the same as the on-campus exam.

(Fields marked with a * are mandatory)

NOTE: New fee payment information

There is a new process in place for the collection of the $30 (per exam) off- site exam administrative fee. Instead of collecting payment via certified cheque and money order, the University will now be charging the fee to the student's York University financial account (same place as tuition is charged).

  1. Students with outstanding fees owing from previous terms will see a charge show up in their student account for the services rendered.
  2. Students that have already paid their fees will not be impacted by this change
  3. Moving forward, for future exams (August 2017 and after), your Student Financial Account will be charged the $30.00 Off-site exam fee upon submission of your Off-site Exam Request form. The fee is non-refundable.

Payments can be made via the regular means of payment. For more information about payments visit the Your Student Account page.

If you have any questions about your off-site exam or fees, please email before submitting your Off-site Exam Request form.

Student Information:
First Name*:
Last Name*:
YorkU E-mail Address*:
Student Number*:
Current Address:
Address on Location*:
(e.g. 123 Main St, NewYork, USA)
Postal Code*:
Cell Phone Number*:
* I confirm that the local/current location and address I reside and have provided above is the same location I will be writing my exam, and that it is more than 3 hours travel time from York University's Keele Campus in Toronto, Ontario Canada.
Permanent Address:
Postal Code*:
Home Phone Number*:
Course Information:
Course ID#*:
(e.g. ADMS 3530 G)
On-Campus Exam Date*:
On-Campus Exam Time*:
Course Instructor's name*:
Time Zone Difference*
(how many hours ahead or behind Toronto time):
Reason for not attending On-Campus Exam*:
Special needs:

If you are a student registered with the offices noted below, please forward the official documentation that confirms your registration and accommodation/special needs to our office.

Invigilator Information:
Invigilator Name*:
Academic Position Title*:
Academic Institution, University/College or other*:
Institution Mailing Address*:
Institution City*:
Institution Province/State*:
Institution Country*:
Institution Web Address/URL:
Telephone Number*
(Please include area code numbers):
Fax Number*
(Please include area code numbers):
E-mail Address*:
(Official academic e-mail only, commercial e-mail accounts not acceptable, e.g. hotmail, g-mail)
Off-Site Exam Date Scheduled*:
Off-Site Exam Scheduled Start Time*:

Fee Information:

An administrative fee of $30 (per exam) will be charged to your student financial account upon submission of this form. The fee is non-refundable.

Please provide your initials in the box that you are in agreement of this charge.

For more information about payments visit the Your Student Account page.

Student Account Online Statements become available on the web around the 18th day of each month (subject to change).

If you have any questions about your off-site exam or fees, please email before submitting your Off-site Exam Request form.

eLearning, eServices Office
041, Atkinson (ATK)
96 The Pond Road
York University
4700 Keele Street, Toronto, Ontario, M3J 1P3

Phone number: (416) 736-5831,Toll Free Number (in North America) 1 (866) 261-1790
Fax number: (416) 736-5637

Off-site Exam Cancellations: Students are required to inform our office, the host institution (invigilator), and the instructor prior to the off-site exam date and time. Failure to notify the parties listed above before the off-site exam date and time could result in the loss of your off-site exam payment.

Academic Honesty:

"By signing your name you affirm that you are registered in the course. You also acknowledge understanding that cheating on an exam, including impersonation and plagiarism, is a breach of Academic Honesty and is punishable under the regulations of the Senate of YorkUniversity.”

Please review the York University Senate Policies, Procedures and Regulations on Academic Standards, Grades, Conduct of Examinations

Today's Date:
Student Initials to verify that all information supplied here is valid*: