AE Form

Request for an Extension to an Assessment Deadline

This form must be used for registering serious mitigating circumstances and seeking an extension to an assessment deadline.

If you do not follow the stated procedure, or fail to complete all documentation as requested, your form will not be processed and your request will be refused.

Personal Details

Student Name:       Student Number:      

Email address:       Telephone Number:      

Unit/module/assessment affected

Course Title      

Module/ Unit Title Type of Assessment or Assignment Date Due                                                                    

Outline of Circumstances

Describe why you are seeking an extension and its proposed length. This is for information only. Your head of department will decide the length of the extension, which will normally be no longer than 20 working days.      

You MUST attach evidence supporting your request e.g. medical note, letter from a 3rd party etc

Student Signature Date

Response from head of department:     

Authorising Signature: Date:

Head of Department, please distribute as follows:

Original for Course recordsCopies to student, course teacher, and personal tutor

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