Request for Time Extension, Self-Paced Training
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Request for Time Limit Extension
Self-Paced Training

If you are having difficulty completing the course before your time limit expires, you may be granted one two-month extension. To request an extension, you may submit this form or telephone us at (866) 448-9740. We will notify you by email of your new course time limit. If you have already received a two-month extension, please call us.
COURSE INFORMATION
Please indicate the course in which you are currently enrolled.
CONTACT INFORMATION (*=Required fields)
Student ID Number: (numbers only)

Prefix:
First Name:
Last Name:
Daytime Phone Number:
E-mail Address:

Course time limit date, if known:

Comments: