an appeal form here

Academic Appeals Form
Please read the guidance notes before completing this
This form, along with all necessary documentary evidence, should be submitted to a Student Hub
who will provide an envelope, or by using your own A4 envelope and checklist, and obtain a
receipt. Alternatively you can email the form in to your Student Hub. Contact details for the Student
Hubs can be found at
1. Personal Details
Mr / Ms
Programme Title:
Address (Please do not give an address you might be moving from in the near future):
Contact Phone Number:
Preferred Email Address:
(Please note – all communication about your appeal will be sent by email)
2. Disability, Specific Learning Difficulties or Long-term Health Conditions
Are you Disabled or do you have a Specific Learning Difficulty (such as Dyslexia) or a long-term
health condition that you believe is relevant to your appeal? (Please select one of options):
No, I do not – Proceed to section 3
Yes - Please give further details below:
3. What Are Your Grounds for Review?
Appeals can only be granted on the following grounds
Performance in assessment was affected by exceptional factors which could not be
notified to the Board of Examiners prior to its meeting.
There has been a material irregularity in the assessment which casts reasonable
doubt on the validity of the result. You will need to explain what material
irregularity has occurred and how it has affected your assessment.
PhD, MPhil and Masters by Research: There has been bias or inadequacy in
the assessment of the work by the examiners.
Please tick
4. Supporting Information
4.1 – Which Units and Assessments Were Affected?
Unit Name and Code (You can find this on
your results letter)
4.2 – What Remedy Are You Seeking?
Please read to the “What if My Appeal is Successful?” section of the guidance notes for information on
possible remedies.
4.3 – What evidence have you included?
 Please list all the supporting evidence you have included with your appeal.
 Remember to include a copy of your most recent results letter
 Guidance on the types of evidence needed to support your appeal can be found in the
guidance notes.
4.4 – Supporting Statement
 You will need to explain your grounds for requesting a review and why you disagree with the
decision of the Board of Examiners
 Continue on a separate sheet if necessary.
5. Certification of Form
(a) Confidentiality
In accordance with the Data Protection Act 1998, we are required to gain your consent to the:
hold some elements of the information you have provided on an electronic database;
disclose the information to authorised members of the University staff for purposes connected
with the investigation of your case
(b) False Claims
Submission of false or fraudulent documentation is an academic offence, which will be dealt with under
the University’s Student Code of Conduct. The University reserves the right to check on the validity of
the document(s) submitted by contacting the third party directly.
By signing here, you confirm that you agree with the above statements and indicate your consent for
the information provided to be used as detailed above.