CSC 104H -- Fall 2012: REQUEST FOR REMARK
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  Student number: ___________________     Lecture section: ___L5101___________


  Last name:      ___________________     Instructor:      ___Heap____________


  First name:     ___________________     Name of TA:      ___________________


  Email address:  ___________________     Tutorial room:   ___________________


  Assignment/Test number: ___________     Date of request: ___________________


Remarking request (be concise and clear, use the reverse if needed):