Request for Special Consideration
Student Name
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First Name
Last Name
Student ID
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Mobile
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Email
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example@example.com
Select your Course
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Please Select
Bachelor of Business (Accounting)
Bachelor of Information Technology
What Special Consideration is Requested (e.g./ extension of time; deferred exam/test; supplementary assessment because of factors affecting your performance; change of study load; other:
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Select the supporting document/s.
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Medical Certificate (A medical certificate must be completed and signed by a medical practitioner (doctor) registered in Australia. Medical certificates obtained from an on-line service where there is no physical examination by a doctor are not considered as being in the patient’s best interests by the Australian Medical Association and may not be accepted as evidence in an application for Special Consideration)
Witness Statements
Other
Attach Supporting Documents here
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What Extenuating Circumstances Qualify you for Special Consideration? Provide as much detail as possible, including circumstances that apply. (Documentary evidence must be attached)
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What outcome do you expect?
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Assessment extension
Deferred exam
Term deferment
Other, please specify
I authorise Gateway Business College to contact the document provider to confirm the authenticity of the attached document.
Signature
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