Reasonable Adjustments application and notification form.
Reasonable Adjustments and Special Considerations ensure that a learner’s disability, learning difficulty or access requirements are taken into account when planning assessment. This document must be used for the following: 1.Centre Awarded Reasonable Adjustments 2.Reasonable Adjustments which need to be approved by FutureQuals. Special Consideration applications - Please contact FutureQuals Please refer to the current Reasonable Adjustment and Special Considerations Policy on the FutureQuals website.
Centre Awarded Reasonable Adjustments
Centres must complete this form when they wish to make a reasonable adjustment to an internally /centre set assessment or examination, which the FutureQuals Reasonable Adjustments and Special Consideration policy states can be made at the discretion of the centre. FutureQuals requires centres to keep a log of all reasonable adjustments, including those that have been declined.
Reasonable Adjustments Application Form
Please complete a separate form for each learner and submit with the appropriate supporting evidence at least 10 working days before the assessment date for applications that require approval by FutureQuals and at least 5 working days before a centre approved adjustment is applied.
Centre or FutureQuals approved
Centre and FutureQuals approved
Does the reasonable adjustment apply to all units?
If no, unit numbers to which the reasonable adjustment is to apply
Proposed assessment date:
Proposed assessment method(s):
If other, please add details here:
Details of the application:
Reason for application
If other or disability as defined by the Equality Act 2010, please provide additional information
Reasonable adjustment(s) requested. Please only select those for which you have supporting evidence.
Extra time up to 25% (please state amount below if under 25%)*
Extra time over 25% (please state amount below)*
If other, please provide details of reasonable adjustment(s) requested
*Please provide % extra time required if over or under 25%
Please upload evidence in support of the application here:
Drag and drop files here
Choose a file
Please provide details of access facilitator(s) (if applicable):
I confirm that: The information provided is accurate;- The centre will be able to provide the arrangements requested; The reasonable adjustments will be implemented in accordance with FutureQuals’ guidance
Email (confirmation will be sent to this address)
Position in centre
Centres should note that a negative decision can be appealed
(please see FutureQuals’ Appeals Policy)
Should be Empty:
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