Attachments

 

 

 

Quality Handbook

 

Extenuating Circumstances Form

If you apply for extenuating circumstances and then hand in assignments or sit an exam, you deem yourself ‘fit to sit’ and this application will then become void and your request will be discounted.

 

Student Name_________________Student Number ________________________

 

Programme_______________Stage_______Faculty/Department:_______________

 

Location of study (delete as applicable, and if partner college please give name):   

 

Sunderland Campus
University of Sunderland in London

University of Sunderland in Hong Kong
Partner or Collaborative College please give name of college:

 

Students on Combined Subject Programme only: Please delete as appropriate

Subject 1 ______________Major / Dual / Minor   Subject 2 ______________Major / Dual / Minor

 

 

 

All the following boxes must be completed when applying for extenuating circumstances, if more than one assessment has been affected please specify them all:

Module

Code

Sem

1/2/3

Module Title

Exam / Test

Dates

Coursework/

Portfolio

Submission Dates

 

Placement

Dates

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Summary. Please give a justification for extenuating circumstances in the box below:

 

 

 

 

 

 

 

 

 

 

 

Please note: Form(s) of evidence must accompany this form.   If extenuating circumstances are on medical grounds, medical evidence must be provided or a letter from a counsellor.  If extenuating circumstances are on other grounds, appropriate documentary evidence must be provided.

I have read the University’s Regulations on consideration of Extenuating Circumstances. 

 

I understand that if I subsequently engage in the assessments listed on this form I declare myself ‘fit to sit’ and this application will be disregarded. I declare that the information I have given on this form is true and accurate.

 

Student Name:  


………………………………………………................................

 

Student Signature:

 

………………………………………………………………………

 

 

Submission Date:

 

…………………………………………….

 

Hand-in arrangements

 

Please submit your request and evidence to the Gateway, located at City Campus or Prospect Building at St. Peter’s Campus or e-mail your completed form to the relevant team: 

 

If you are a student of:

 

University of Sunderland in London-studentadmin-london@sunderland.ac.uk

Faculty of Arts and Creative Industries - faci.ec@sunderland.ac.uk

Faculty of Business, Law and Tourism -fblt.ec@sunderland.ac.uk

Faculty of Computer Science -fcs.ec@sunderland.ac.uk

Faculty of Engineering and Advanced

Manufacturing -feam.ec@sunderland.ac.uk

Faculty of Education and Society -fes.ec@sunderland.ac.uk

Faculty of Health Sciences and Wellbeing -fhsw.ec@sunderland.ac.uk