Assessment Extension Request Form

Assessment Extension Request Form
Before you begin – Important information about extension requests

Please read the MIECAT Assessment and Moderation Policy prior to completing this form. The policy outlines in further detail important information about extensions under Section 4.3.4 (pages 7-10).

For any extension longer than 1 week, you’ll need to upload supporting documentation. This is part of our Assessment & Moderation Policy and helps us understand and respond to your circumstances fairly. Examples of appropriate documentation include:
- A statutory declaration (if no other documentation is available)
- A self-certifying written statement explaining your circumstances
- A medical certificate or letter from a health professional
- A police report
- A death certificate or funeral notice
- A letter from your religious leader
- A letter from your employer
Please let us know your first and last name.*

First NameLast Name
What is your MIECAT email address?*
example@miecat.edu.au
Our email hidden
example@example.com
What subject are you requesting an extension for?*

Unit 1Unit 2Unit 3Unit 4Unit 5Unit 6Working RelationallyAttending to ProcessWorkplace Practice 1Workplace Practice 2Mid-year Unit 1Mid-year Unit 2Mid-year Unit 3Mid-year Unit 4Prof Doc RS1Prof Doc SS1Prof Doc RS2Prof Doc SS2Prof Doc RS3Prof Doc SS3Prof Doc RS4Prof Doc SS4Prof Doc RS5
Who is your class teacher or supervisor for this subject?*
What is the original due date of your assessment?*

DayMonthYear
Date
What length of extension are you requesting?*

1 week2 weeks3 weeksOver 3 weeks
Number
New Due date
If you are requesting an extension of over 3 weeks, please enter a proposed new due date below.*

DayMonthYear
Date
Which category best describes the reason for your extension request?*

Health relatedEmploymentFamily or personal circumstancesCaring responsibilitiesLegal obligationsUnexpected event(s)Technology issuesOther
Please outline the reasons you are requesting an extension.*
All extension requests longer than 1 week must be supported by documentation. Suitable documentation includes a medical certificate, a letter from your employer, or similar. Please upload your supporting document(s) below.*

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