SAS - M
MITIGATING CIRCUMSTANCES FORM
This form must be returned to your home academic department
This form must be used by students who wish to inform the University of circumstances which they feel
may have affected their performance in assessments or led to them being absent from an examination.
To request a coursework extension before the submission date – use form SAS-EXT. Exceptionally, you
may use this form to request mitigation where you have been unable to submit coursework on time and
were unable to request an extension in advance.
There is a standard deadline for claiming mitigating circumstances of 7 days after the assessment.
Before completing the form, please ensure that you read in full the notes at the back.
This form is available to students, and should be completed by the student, or on their behalf with their
knowledge and agreement.
Section 1 – Student Details – to be completed in all cases
Your Full Name
________________________________________________
Registration Number
__ __ __ __ __ __ __ __ __
Full Title of Programme of Study ________________________________________________
(e.g. LLB Law with German)
Faculty
_____________________
Location of Study
Hull
Current Year of Study
Department __________________________
Scarborough
__
Other
________________________
Full time
Part time
Section 2 – Details of assessments affected
You must clearly state each assessment that you believe has been affected by the mitigating
circumstances. Assessments not listed will not be considered.
Module Code
(5 digit no.)
Module Title
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Assessment Affected
Date of
Assessment
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Section 3 – Your circumstances
Use this space to describe fully the circumstances that have affected you. You must put as much detail
as possible, to ensure that a decision is reached on full information. If this request is related to a disability
or medical problem which is known to the University and for which recommendations related to
assessment have been made previously, please indicate this clearly below.
Section 4 – Effect on assessments
Describe clearly how the circumstances affected your ability to prepare for, or to undertake the
assessments listed in Section 2.
Section 5 – Evidence
What evidence of your circumstances are you including to support your request? Evidence is required for the
circumstances, their effect on your assessments and if relevant, why the request was made late. For medical
circumstances, evidence may be a letter from a doctor or nurse, confirmation of an appointment, prescription, etc. If
no evidence is available, you may wish to use form SAS-GP to request information from a medical professional.
(Securely attach to this form all evidence that you wish to be considered.)
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Section 6 – Previous Discussions
Please indicate if you have already discussed these circumstances with a member of University staff.
Yes

No

Staff Name _________________________
Dept. ________________________
Date ___________
Section 7 – Late Submission
Only if more than 7 days have passed since the assessment in question.
Requests submitted more than 7 days after the assessment are not normally considered. Why was it not
possible to raise these circumstances within 7 days of the assessment?
Section 8 – Declaration
I declare that I have read and understood this form before completing it, and that the information provided on and
with this form is accurate and complete to the best of my knowledge. I understand that to seek to gain an advantage
or benefit (such as a new exam attempt) through providing false or misleading information is liable to action being
taken against me under the University Code of Practice on the Use of Unfair Means.
Student signature
______________________
Date ____________
When complete, forward this form and all evidence to your home academic department.
Section 9 – Academic Department Use Only
Date received in Department
________________
by
____________________
Action taken by Department
Ensure that this form is copied to all relevant departments. Forward to the Secretary of SPC only if received more
than 7 days after the assessment in question or in cases that prove difficult to resolve and advice is sought. Please
attach to form SAS-S, as a “Consideration of Late Mitigating Circumstances”.
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General Information for Students
After completion, you are advised to make a copy for your own records, and you must then submit the
form to your home department (the one responsible for your programme of study).
Note that there are only 3 acceptable reasons for being absent from an examination:
1.
2.
3.
medical circumstances occurring at the time of the examination (provided they are supported by a
medical certificate or other evidence issued by a qualified medical practitioner or a qualified
counsellor)
bereavement of family or close friend (including attendance at funeral) (a letter from an appropriate
person confirming the details should be provided – a copy of the death certificate is not required)
being unable to get to the examination because of the failure of properly made travel
arrangements beyond your control (corroborating evidence will be required). (Your car breaking
down on the way to the examination will be accepted; not arranging a flight which will arrive in
good time will not).
If your circumstances are not accepted:
The original mark for the assessment will stand, (or you will receive a mark of 0 for non attendance).
If your circumstances are accepted:
The circumstances will be passed to the Module Board of Examiners who will decide to either:
1.
2.
3.
4.
award you a new attempt at the examination or assessment, if you so wish – this is the default
decision
pass the matter to the Programme Board of Examiners for consideration later
award a bare pass in the module (this is only done in very exceptional circumstances)
decide that the circumstances do not merit any action
If you are awarded a new attempt, and you accept the offer, your original attempt is wiped from the record
and your original mark is lost and cannot be reinstated, even if you subsequently fail or receive a lower
mark for the new attempt.
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