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PGT Mitigating Circumstances Online Declaration Form

This form is only for use by any student registered on either the MSc in Diabetes Care or PG Diploma in Diabetes in Primary Care courses (delivered by iheed).

The form should be completed if you want to make the University aware of any mitigating circumstances which you believe may have adversely affected your performance either during the year or in relation to one or more assessment. Please read the University Mitigating Circumstances guidance before completing the sections which apply to you. Upcoming Deadlines: Wednesday 20 May 2020 - all cases to be submitted that need to be considered ahead of the summer Examination Board meeting that will be held on 2 June 2020. Forms will not be accepted after the deadlines stated unless there are exceptional reasons


 
Please state the type of mitigation you are presenting (you may select more than one type and if other please provide details):
Please state the type of mitigation you are presenting (you may select more than one type and if other please provide details):
Please state the length of time/period affected (giving dates), and details of any assessments affected (timeliness):
 
Please indicate who you have contacted in relation to your mitigating circumstances (please select more than one option if applicable)
Please indicate who you have contacted in relation to your mitigating circumstances (please select more than one option if applicable)
Have you been granted an extension or taken Temporary Withdrawal (TWD) for this Mitigating Circumstance already
Have you been granted an extension or taken Temporary Withdrawal (TWD) for this Mitigating Circumstance already
PART TIME STUDENTS ONLY Have you been granted sick leave from work for this Mitigating Circumstance
PART TIME STUDENTS ONLY Have you been granted sick leave from work for this Mitigating Circumstance
Attach file
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Please indicate which exam board recommendation you are seeking through this claim:
Please indicate which exam board recommendation you are seeking through this claim:
By submitting this form you are confirming that the information you have given is true and that you have read and understood the University Guidance on mitigating circumstances.
 
Privacy statement
Please note that the information you provide will be reviewed by the departmental mitigating circumstances pre-board in order to make a recommendation to the Board of Examiners about your case. The University will keep your full student record for six years after the end of the academic year in which you graduate from, other otherwise leave the University. After six years, the University will retain only the data necessary to identify you and confirm the dates you studied at the University, the degree and classification you were awarded and a transcript of your marks. All other personal data on your student record will be disposed of in a secure manner.
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