Submit New Application

Request for Testing Extension Application

Please read these directions completely before you complete this form online.

Your application is not complete until the required information is included, with a detailed explanation as to why the request for an extension is being submitted, then select 'Send Application'.

Legal First Name

Middle

Legal Last Name

Suffix

Birthdate

Phone

SSN

Gender

Male Female Other

Address

City

State

Zipcode

Reason

Provide a detailed explaination of the circumstances that occurred and the reason you are requesting a testing extension.

Supporting Documentation

Please upload supporting documentation

Affidavit

I have provided detailed explanation as to why the request for an extension is being submitted.
I understand it is my responsibility to contact D&SDT-Headmaster to confirm that any documentation has been received.

I agree that if all the requested documentation is not submitted with the application, and I do not reply to any of the D&SDT-Headmaster's *emailed requests within one (1) month of submitting my application, my application will be denied.

By Submitting

I hereby verify that I understand and agree with the statements contained herein and the above information is true and correct.