Reasonable Adjustment Application Form

Student ID

Given Name(s)

Surname

Telephone Number

Email Address

Current Address

Course and Unit

Students with a medical condition or disability may request for reasonable adjustment to an assessment task by completing this form
Students must apply for reasonable adjustment in writing to their relevant Academic Director at the earliest opportunity upon enrolment or as soon as their condition is diagnosed to ensure that reasonable adjustment can be made available within required time frame
Attach medical certificate or any other relevant supporting documents with the Application Form
Please refer to the Assessment Policy and Procedure before completing this Application Form.

Grounds and Details for Reasonable Adjustment

The reasonable adjustment requested (specific details required)

The reason for the requested reasonable adjustment (specific details required)

Student Declaration(Required)

I declare that the information provided in this application is accurate. I have read and understand the information about the reasonable adjustment process as outlined in the Assessment Policy and Procedure.

If it is for the office use.

Official Use Only

Received By Name

Reviewed By Name

Reasonable Adjustment Decision/Comments

Level 2, 1-3 Fitzwilliam Street, PARRAMATTA NSW 2150
Level 1, 37 George Street, PARRAMATTA NSW 2150

Our Campus

Campus Safety
Medical and Emergency Facilities
Campus Map
Careers at SCI
Events

Campus Life

Policies and Procedures
Privacy Policy
Copyright
FAQs

Academics

Library
e-Learning
Apply For Admissions
Pay my Tuition
Leave a message