Assessment Extension Application Form

Student ID(Required)

Given Name(s)(Required)

Surname(Required)

Telephone Number

Email Address(Required)

Please use your College outlook email address.

Current Address

Course

Major (if applicable)

Semester

Date

For your Assessment Extension application to be assessed you must:

Complete all sections below;
Attach a personal statement outlining the reason for you assessment extension request;
Provide supporting documentary evidence;
Submit your application supporting documents to the Student Support Officer in person at the SCI Campus - Level 2, 1-3 Fitzwilliam Street, Parramatta NSW 2150 or Level 6, 31-39 Macquarie Street, Parramatta NSW 2150, or send via email to [email protected] within five (5) days of the assessment due date.

List(Required)

Unit code and Name

Assessment Type (exam/assessment/quiz)

Assessment Submission or Exam Date

Extension reason (Please write the reasons here)(Required)

Supporting File

Drop files here or

Max. file size: 128 MB.

I understand the requirement for this application and will submit:(Required)

This application form;

My personal statement;

Supporting documentary evidence.

Student Signature

Date

If it is for the office use

Received By

Signature

Date

Reviewed By

Signature

Date

Decision

Academic Director Signature

Date

Dean (or nominee) Signature

Date