Nursing Challenge Examination Request Form


Date of Examination:
Time:
Student's Last Name:(please make sure to put what appears on your ID)
Student's FirstName:(please make sure to put what appears on your ID)
Student's Email Address :
Student's Phone Number:
Nursing Course being challenged:
   
I have made the payment of $75 dollars at the Registrar's Office
I understand that I need to bring the receipt from the Registrar's Office and my ID before I will be able to take my exam.