UWL MITIGATING CIRCUMSTANCES FORM
FORM M
‘Mitigating circumstances are circumstances that are outside a student’s control which may have a negative impact on a student’s ability to undertake or complete
any assessment so as to cast doubt on the validity of the assessment as a measure of the student’s achievement.’
Have you consulted the Students Union Caseworker on the filling in of this form: YES/NO
Sections A and B must be completed by the student and submitted to the Academic Schools Administration Centre/ Administration Offices Reception Paragon within
10 WORKING DAYS of an affected examination, practical, or affected coursework/dissertation/project deadline.
SECTION A
(to be completed by the student):
Student name: _____________________________________________________________________ID number: ____________________
Course: ___________________________________________________________________________Year of study___________________
Name of personal tutor: ___________________________________________________________School/College:____________________
Please indicate why the form is being completed by ticking the appropriate box or boxes:
 Absence from an examination/practical, or non-submission of coursework
 Issues with an assessment that has been attempted
 Other_______________________________________________________________________________________________
Nature of circumstances (to be completed by the student) – for full details of required evidence consult Appendix 1 of the Policy








Illness/Hospitalisation (Evidence: A medical certificate or letter)
Family illness (Evidence: A medical certificate or letter)
Bereavement - death of close relative or friend (Evidence: Death certificate or supporting letter from an independent professional source)
Acute emotional/personal circumstances (Evidence: Letter from the University Counselling Service or equivalent and/or medical evidence)
Victim of crime (Evidence: Crime reference number plus any written evidence available from the police)
Domestic disruption (Evidence: Appropriate professional letter)
Jury Service/Court Attendance (UK) (Evidence: Court or equivalent letter)
Other – please give details in Section B overleaf and provide supporting documents
Do you have a current Independent Support Plan: YES/NO
NB: Forms which are not fully completed and without the required documentary evidence will not be considered. Where evidence is not available by the deadline for submission of the
form, the form should be submitted as required and appropriate evidence must be submitted within 20 working days of the coursework deadline or affected examination. If the
evidence is not in English an authenticated independent translation must also be attached.
SECTION B
1.
Further details (to be completed by the student and School/College/Department):
Is supporting documentary evidence attached to this form?
Yes / No
If Yes please give brief details of attached evidence:





The Academic Regulations set out full information on the type and quality of evidence required, and gives examples of circumstances not normally considered as acceptable reasons.
All evidence submitted in support of a mitigating circumstances claim will be treated with full confidentiality in accordance with the Data Protection Act and will be disclosed only to
appropriate members of staff.
Note. Any student wishing to restrict the sharing of such information should submit this evidence into an envelope marked ‘Chair’s eyes Only’ so that
only the Chair reviews the case.
Is supporting documentary evidence being submitted separately?
Yes / No
Note: Supporting documentary evidence should be submitted within 20 working days of the coursework deadline or examination.
2.
The student should state below the effect that the extenuating circumstances have had on their performance, including the number of days
affected and other relevant information. Please attach another sheet if additional space is required.
Note: Before submitting this form to your School/College administration offices students are advised to discuss their claim with their Personal Tutor/Course
Leader/and Student Union Caseworker before completing.
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
Once completed and signed by your Personal Tutor/Course Leader the form and evidence should be handed in to your School/College Administration Offices.
Forms will not be processed that have not been submitted this way.
Please tick the appropriate box for your School:
 Administration Offices Reception, 4th Floor Paragon House – Claude Littner Business School, College of Nursing, Midwifery and Healthcare and Psychology,
Social Work and Human Sciences
 Academic Schools Administration Centre, HT GF 004 – Ealing Law School, London College of Hospitality and Tourism, London College of Music, London
School of Film, Media and Design and School of Computing and Technology
3.
All assessments that are being mitigated for by the student should be included in the table below. Please expand or attach another sheet if
additional space is required.
Note: This includes absence from Examinations, non-Submission of Coursework and/or Assessments that have been completed but affected
For Completion by Student (all information must be completed or the form will be returned for completion of information)
Module Code
Module Title
(Please enter each affected assessment on a
separate line)
Assessment
Period affected
(delete as
applicable)
Assessment Affected
(delete as applicable)
Original date of
examination/
coursework
deadline
Preferred
outcome*
(delete as
applicable)
Semester 1/2
Exam/Coursework
1st Sit/Resit
Semester 1/2
Exam/Coursework
1st Sit /Resit
Semester 1/2
Exam/Coursework
1st Sit /Resit
Semester 1/2
Exam/Coursework
1st Sit /Resit
Semester 1/2
Exam/Coursework
1st Sit /Resit
Semester 1/2
Exam/Coursework
1st Sit /Resit
Explanation of 1st Sit/Resit:
‘1st Sit’ means that there would be an opportunity to attempt the assessment again as a replacement uncapped attempt for the affected assessment mark
(i.e. sit the exam at the next exam period – or submit new coursework).
‘Resit’ means that there would be an opportunity to attempt the assessment again as a replacement capped attempt for the affected assessment mark. The
resit mark would be capped at the minimum assessment mark threshold for that assessment. (i.e. sit the exam at the next exam period – or submit new
coursework)
4.
Student confirmation
I confirm that the information provided is true:
Signed (Student): _______________________________________________________
Date: _______________________________
This form is available to download in word format at http://www.uwl.ac.uk/students/current-students/extensions-and-mitigating-circumstances
All enquiries should be addressed to mitigation@uwl.ac.uk
SECTION C: To be completed by the Personal Tutor/Course Leader (delete as appropriate):
I have/have not seen the student on behalf of the School/College (delete as appropriate)
Personal Tutor/Course Leader/Module Leader (delete as appropriate) comments:
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
Name: ___________________________________________________________________Signature____________________________Date: _________________
For Staff Use only:
Sent from (Please tick):
 Administration Reception, 4th Floor Paragon House – CLBS, CNMHC and PSWHS
 Academic Schools Administration Centre, HT GF 004 – ELS, LCHT, LCM, LSFMD, and SCT
Date received___________________________________
Name of Course Administrator_________________________________________ Signature_________________________
SECTION D: EXPLANATORY NOTES
1.
A student may apply to the Course or Module Leader for an extension in response of any element of assessment, with the exception of an
examination. The application must be made prior to the applicable deadline and must be made in writing using Form E (Extension request
proforma).
a)
Should this not be enough time for the student to complete their work they have the option to make a mitigation claim. However, the student
must remember that according to the University Academic Regulations ‘Mitigating circumstances are circumstances that are outside a
student’s control which may have a negative impact on a student’s ability to undertake or complete any assessment so as to cast doubt on
the validity of the assessment as a measure of the student’s achievement.’ Any claim that does not fulfil these criteria will not be classed as
mitigation and rejected.
b)
Advice can be sought from the Student Union Caseworkers on what is required for an extension and mitigation claim via this link:
http://www.uwlsu.com/main-menu/advice
2.
Please read the Academic Regulation pertaining to Mitigation for further details on the following:
a)
Students must present mitigating circumstances requests using the University pro forma no more than ten working days after the failure to
attend an assessment to the School/College Administration Offices.
Note: Submissions by staff or other students cannot be accepted on behalf of a student.
b)
Late submissions over the 10 working day submission date shall not be considered. Late submissions on the grounds that the student was
unwilling to disclose the information at an earlier date shall not be accepted.
c)
Submitted forms must be supported by appropriate evidence within 20 working days of the assessment date and all evidence sent to the
relevant School/College Administration Offices.
d)
Cases will not be submitted to a board where the claim is not complete and will be returned to students and for further information and
evidence where they are missing the following:
a.
b.
c.
d.
e.
f.
g.
the form has not been appropriately completed
evidence is missing
evidence is either illegible or not written in English;
there is a mismatch between the timing of the claimed circumstances and the period of assessment.
The medical evidence in support of this application is not certified by a registered medical practitioner
Evidence is not directly relevant to the circumstances and timing of assessments as appropriate; even if concerning a long term
medical condition.
There is no evidenced link between the students and people mentioned in their evidence.
e)
Circumstances which could lead to a successful mitigation request may include the following:
a.
b.
c.
d.
e.
f.
g.
ill-health – physical or mental;
severe financial hardship, i.e. over and above that experienced by all students;
emotional/personal difficulties – e.g. bereavement;
disability i.e. where the student’s disability comes to light for the first time at assessment;
unavoidable absence from the University – e.g. unforeseen requirements of employer;
unavoidable absence from domicile – e.g. eviction;
other serious circumstances which could not be foreseen by the student.
Note: The above examples are for illustration only and not intended to be definitive or exhaustive.
f)
Evidence of personal problems must be documented, and supported by appropriate independent professional statements.
Note: Any costs incurred in supplying evidence are the responsibility of the student, and the University reserves the right to contact any
person named in an application for mitigation to seek clarification or further information including checking the authenticity of the
evidence submitted.
Any enquiries should be addressed to mitigation@uwl.ac.uk
Relevant links:
Mitigation Regulations and Appeals - http://www.uwl.ac.uk/students/current-students/extensions-and-mitigating-circumstances
Policy - https://www.uwl.ac.uk/about-us/academic-policies-and-regulations