Assessment Special Conditions – Student Application
Section 1: Student Declaration
Personal Information
Student Number
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I am a
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Morling student
Cross-Institutional student
Current Study Mode (choose all that apply)
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Full-time
Part-time
On-Campus
Online
Surname
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First Name/s
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Email Address
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Current Award/Course
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Main campus
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Please Select
Brisbane
Perth
Online only
Sydney
Extension campus: (Melb/Gold Coast/other)
Primary Course Advisor (if known)
Are you an Overseas Student (studying here on a Student Visa)?
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Yes
No
Nature of Disability or Medical Condition. Please indicate which category/ies your disability/condition best fits into:
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Hearing
Mobility/Physical
Vision
Neurological
Learning
Mental Health
Other Medical
Other
Please indicate whether your disability/condition is:
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Permanent/Chronic
Temporary or Intermittent
Improving
Degenerative
Other
Reason for Application (student to complete)
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Please indicate in your own words why you are applying for special conditions for Assessments and how your disability/condition impacts your ability to study (e.g. inability to sit for long periods, medical effects, reading/comprehension speed). Feel free to attach further personal details or documentation (not medical documentation) below if necessary.
Upload any additional personal documentation here (optional):
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What type of assessments are you applying for special conditions for?
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Assessments within Semester (eg essays, journals, reflections)
Exams
For what time-frame are you applying for special conditions?
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This Semester only
This and future Semesters (permanent disability/condition)
Section 2: Medical Practitioner Supporting Documentation
Please upload a clear scanned copy of any relevant medical forms that speak to your situation here. You can also ask a Medical Practitioner to complete a separate form/s which can be found on Moodle under the Course Essentials drop down menu.
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multiple file uploads are permitted
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Student Declaration
Signature
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Date
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Day
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Month
Year
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