EXTENUATING CIRCUMSTANCES
SUPPORTING EVIDENCE
Guidance for applicants
Use this form to provide details of how your extenuating circumstances have directly affected your
studies. This application should be accompanied by appropriate documentary evidence providing
independent third-party corroboration of the circumstances you submit.
Examples of the type of evidence required include:
Extenuating Circumstance reason
Significant illness or injury to self
Death or critical/significant illness of a close
family member/dependent
Family crisis or major financial problems
leading to acute stress
Absence for jury service or maternity,
paternity or adoption leave
Victim of crime
Work commitments (in rare cases)
Example evidence
 Medical certificate or prescription
 Hospital letter or note
 Appointment card
 Death certificate
 Obituary notice
 Newspaper article
 Medical certificate/hospital letter or note
 Documents relating to the issue
 Statement from independent professional,
including counsellor, victim support or legal
advisor
 Official letters/documentation



Police report
Statement from independent professional,
including counsellor, victim support or legal
advisor
Letter from employer
First Name ................................................................. Surname ..............................................................
Student Id/Enrolment Number ..................................................................................................................
Dates affected by ECs:
From: ..................................................................... To: ..........................................................................
Use the space below to describe your ECs: