Examination Extension Request Form

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M.Sc. Software Engineering and Database Technologies / Diploma in Software Engineering
Examination Extension Request Form
Student Name:
Address:
E-mail Address:
Phone Number:
Student ID Number:
Module Name:
Module Code:
Term & Year of Course:
Date of Examination:
Reason for Extension: (in the section below, please outline the reasons for your
request for an examination extension)
Request for new submission date: (to be confirmed with your facilitator)


I will submit the exam within one week of the final submission
deadline.
I will be unable to submit the exam within one week of the final
submission deadline.
Signature:
_________________________
Date: _____________
Email to your module facilitator no later than the end of Week 6
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