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Extenuating circumstances form

Before completing this form, please ensure you have read the Extenuating Circumstances procedure. You must complete all sections of this form before submission.

This form must be completed by the student and submitted within 7 days of an affected examination or before the affected coursework/dissertation/project deadline.

Advice on how to complete the form can be found on the Students Union webpages.

Read the Extenuating Circumstances Policy and Procedures guidance

  • Your details
  • Student Name
  • 1. Please indicate why the form is being completed by selecting the appropriate box or boxes:
  • 3. What work / examinations was affected?
  • 4. What evidence are you providing in support of your claim?
  • Will supporting documentary evidence be submitted separately?
  • Your supporting evidence

    Upload up to four supporting documents. The University reserves the right to request sight of original documents if necessary.

    You can upload documents of these sorts: doc, docx, eml, jpeg, jpg, msg, pdf, png, rtf, xls and xlsx, up to a total maximum of 20Mb.

    You will have the opportunity to send more attachments after submitting the form.

  • 5. Although it isn't mandatory for you to speak to someone before you submit a claim, staff members can provide helpful advice, if needed. If you've been speaking to someone about the circumstances affecting your study, it can be helpful for the Panel to know this.
  • Student signature and consent
  • The information I have provided is correct and complete to the best of my knowledge. In submitting this form I given my consent for this information to be disclosed to relevant Examiners and Officers of the University responsible for considering my claim. I understand that the claim will be kept on my University record.