Florida Civic Literacy Exam (FCLE)

Retake Request Form

This form is for students who attempted the FCLE at least two times and are requesting an additional attempt.

Who is making the request?*

Student Advisor Testing and Assessment Staff Other

Campus/Location associated with managing this request*

Hialeah Homestead Kendall Medical North/MEEC Padron West Wolfson

Select the School related to the student's program*

Health Science Nursing

Is the student expected to graduate this term?*

Yes No

Requester's Name*

First Name

Last Name

Requester's Email Address*

Requester's Phone Number*

Student's Name*

First Name

Last Name

Student's Middle Name

Student's Date of Birth*

Student's Phone Number*

Student's Email Address*

For which attempt is the FCLE requested?*

Third attempt Fourth attempt or more

Test Date of last FCLE attempt

Please provide additional information to support this request