Sheffield Hallam University Form Ec1 Issue 03/13 Notes For Completion and Submission of Extenuating Circumstances
Sheffield Hallam University Form Ec1 Issue 03/13 Notes For Completion and Submission of Extenuating Circumstances
Sheffield Hallam University Form Ec1 Issue 03/13 Notes For Completion and Submission of Extenuating Circumstances
Form EC1
Issue 03/13
Illness
o medical note, letter or certificate from GP, hospital consultant, SHU Medical Centre, dentist, or health practitioner
such as osteopath, - this must contain a clear medical diagnosis or opinion and nor merely report your claim that you
felt unwell, nor report your claim that your had reason to believe you were ill.
o self-certification declaration for short illness (1 5 days duration using University procedures - Please note: selfcertification would not normally be accepted for coursework)
o hospital appointment cards (showing name/dates),
o prescription or medicine labelling (showing name/dates),
Theft or burglary: crime report and number
Exceptional work commitments: letter from employer
Unforeseen transport difficulties which could not have been avoided: letter from transport company
Criminal investigation or proceedings, litigation, other legal matters: solicitors letter
Personal or domestic problems: letter from someone in a professional capacity who has direct knowledge of the problems
and / or has been involved in supporting the student
holidays
To complete this form you will need the following: personal details
module/s affected, including exact details of each assessment task which has been affected
documentary evidence to support how your performance has been affected by your circumstances in these assessments (eg medical note, letter from student counsellor)
Once you have completed all sections and all boxes of the form and attached your evidence, you must submit it to your Faculty Reception
If you are submitting your form directly to the Chair due to exceptional confidentiality reasons (see section 4D of the Extenuation Policy), please provide details of the member of staff
to whom you have made your circumstances known.
You must submit your EC1 form no later than 5 days after an examination/deadline date for coursework assessment. Forms received later than this will only be considered in
exceptional circumstances if there is a valid reason for the late submission of the form supported by documentary evidence.
I am submitting my EC1 form late
YES / NO
My EC1 form is late because ...
...
PERSONAL DETAILS
Name
Student ID Number
Faculty
Course Title and Year (eg 1,2)
Course Code
Mode of Attendance
Academic Year
Semester
Contact telephone number
Name of
Module(s) and
Module code(s)
(only listed
modules will be
considered)
Assessment task
affected (eg name
of assignment,
presentation,
examination)
Deadline date
of coursework,
date of
examination
(as
appropriate)
Course work
only
Have you
had an
extension?
Please tick as
appropriate
No
Yes
If yes date of
extension
Non-submission/non-
attendance
Underperformance
(please only
No
Yes
If yes date of
extension
No
Yes
If yes date of
extension
No
Yes
If yes date of
extension
No
Yes
If yes date of
extension
Explain how the circumstances affected your ability in the assessment task. The key information to include is what the circumstances are, how the relevant
assessments have specifically been affected, what support you have sought/received and include dates where relevant. Please be as clear and concise as
possible. Remember that the panel are impartial and will therefore only reach a decision based on the information provided on the form. If you have a
Learning Contract, please also complete the box at the end of section 3. Please continue on a separate sheet if necessary
DOCUMENTARY EVIDENCE
Please list the supporting evidence that you will be providing or reasons why documentary evidence cannot be attached. It is important that
documentary evidence includes details of the circumstances, relevant dates/duration and where possible, its impact. Some examples of documentary
evidence can be found on the front page of the EC1 form. (Point 4).
5.
For use by University staff eg Module Tutors, Course/Programme Leaders, Student Support Officers, Counsellors, Multifaith Chaplaincy staff:
Students are not obliged to discuss extenuating circumstances claims with staff, but if a student has discussed this claim with you and has asked you to comment in writing, and if you have sufficient
knowledge to do this, please write any comments below and return this form to the student.
Please note that the EC Panel will take factual information and evidence into account but will not normally take account of statements which only offer support but give little or no factual details.
Date ..
Correctly listed all the assessments you believed were affected and their dates (see section 2)?
Fully completed the boxes under each of the headings in section 2? Tick here when you have checked
Linked the timing of the circumstances with the assessments you listed (see section 2)? Tick here when you have checked
Clearly explained what your extenuating circumstances were and how they affected assessment (see section 2 and 3)? Tick here when you have checked
Attached independent documentary evidence about your extenuating circumstances? If not, have you explained why? (see section 3) Tick here when you have checked
CERTIFICATION OF FORM
I certify that:
- the information I have given on this EC1 form is correct to the best of my knowledge
- I have attached to the EC1 form all the documents listed in 3 above
- I understand that appropriate staff will have access to the information provided on this form
Signed ....................................................................
Date:.............................................................
Date .............................
BEFORE YOU SUBMIT THIS FORM, PLEASE READ CHECKLIST ABOVE AND CHECK THAT YOU HAVE COMPLETED FORM CORRECTLY
For Office use only