Special Consideration Form Professional Education students

Special Consideration for Professional Education students
Before completing this form you should read the Special Consideration Policy for Corporate and Professional Qualifications students. If you have any queries please call us on +44 (0)1227 818609 or email support@libf.ac.uk. You must return the completed form together with the supporting evidence within 5 working days of first notifying us. Please note that incomplete application forms may not be accepted.

Your Details
LIBF Number (if known)
LIBF Number
Title
Name*

First NameMiddle NameLast Name
Date of Birth*

DayMonthYear
*A date of birth is compulsory to activate your online account.

Special Consideration Application
Qualification name(s)*
Assessment date (if applicable)

MonthDayYear
Date
Does this application relate to an incident during your exam?*

YesNo
Was the invigilator informed about your concern(s)?

YesNo
Does this application relate to health / personal circumstances*

YesNo
Please provide full details about the circumstances that led to this application, including dates and times relevant to your studies.*

Evidence
Please confirm what evidence you are providing to support your claim and all documents need to be uploaded.*

Medical appointment / Health certificateDeath CertificateLetter (on headed paper) of support / explanation from a Line Manager / HR at place of employment.Letter from GP / Medical practitioner, relevant to the circumstances of your application.Other
Documents to support claim your request cannot be considered without evidence*

Cancelof
If your application is successful what would be your preferred outcome?*

Declaration
Your Personal Data

We will use and protect your personal data in accordance with current data protection legislation to evaluate your claim. Further details, including your rights, the disclosure of data to third parties, storage, retention and how to amend your personal data, can be found within our Privacy Notice.
Declaration - you must agree and accept the below to continue:*

I declare that the information contained in this form is true and accurate, consent to the processing and use of personal data as outlined in the Privacy Notice and accept our terms and conditions.I confirm that by completing and submitting this form and associated evidence, I give consent to the processing and secure storing of the evidence provided.
Signature*
A typed signature is accepted that you agree to above declarations
Should be Empty:

Special Consideration for Professional Education students