Exceptional Mitigating Circumstances Form

Exceptional Mitigating Circumstances (EMC) application form

Please read the guidance information about EMC applications on the Academic Registry webpages before completing an application form. The Academic Registry webpages include information on the deadline for submission of an EMC application, it is important that you check this deadline date before submitting an EMC application. You can also contact Edge Hill Students’ Union Advice Centre, for independent advice and representation.

Accessibility: Disclosing a disability is a personal decision and we understand that you may want to keep it confidential. Even if you have not already disclosed your disability, we encourage you to do so at the start of the EMC process. We can offer support and/or reasonable adjustments to help you participate fully in the EMC process and can reassure you of confidentiality throughout. Please email assessmentteam@edgehill.ac.uk if you require the application form in another format.

Please enter your details here

Department (required)

Please state which modules are the subject of this EMC application.
Note: it is your responsibility to ensure your application specifies the correct module codes and all relevant elements of the assessment you are applying for.

Module 1

Module number
Element (eg coursework 1/coursework 2/practice/exam)
Element Detail
Assessment dates
Dates impacted by mitigating circumstances
Is this your first attempt at the assessment?

Module 2

Module number
Element (eg coursework 1/coursework 2/practice/exam)
Element Detail
Assessment dates
Dates impacted by mitigating circumstances
Is this your first attempt at the assessment?

Module 3

Module number
Element (eg coursework 1/coursework 2/practice/exam)
Element Detail
Assessment dates
Dates impacted by mitigating circumstances
Is this your first attempt at the assessment?

Module 4

Module number
Element (eg coursework 1/coursework 2/practice/exam)
Element Detail
Assessment dates
Dates impacted by mitigating circumstances
Is this your first attempt at the assessment?

Your Tutor
As part of the EMC scheme, students are expected to discuss their circumstances with their personal tutor or another tutor from their programme. When you submit an application, we will let your tutor know that it has been received, but we will not provide the details of your circumstances or any supporting evidence. To enable us to do this, please provide the name of your personal tutor or another tutor from your programme below.

Please select here if your EMC claim relates to the coronavirus.
Applications for coronavirus related issues do not require a supporting statement or supporting evidence.

Coronavirus

If your application does not relate to the coronavirus in any way, your application must include the following information:

1. A factual statement (this should detail the reasons for your EMC claim and provide context on how your circumstances have impacted your assessment submissions) (required)
Please upload your statement here:

2. Independent Supporting Evidence
Please attach any supporting evidence here:

Please note: claims for exceptional mitigating circumstances are evidence based. If no evidence is provided your application may be rejected.

Student declaration: Please read and tick box (required)

Data Protection: We are committed to ensuring compliance with current data protection legislation. We confirm that all data collected is used fairly, stored safely and is not disclosed to any other person unlawfully. Edge Hill is a data controller and, in some instances, may process this data. Information about how we use your personal data can be found at www.edgehill.ac.uk/ig/dpa/

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