Request for Additional Assessment Opportunity
Approval by Undergraduate/Postgraduate Studies Committee
Section 1: Applicant Comment
To be completed by the applicant (Section 1 only).
This form should be typed and submitted electronically
It is advisable that you consult with your Programme Director/Supervisor before making an application for
additional assessment opportunities.
Student Name:
School/Institute:
Study Programme:
Location:
Matriculation No.:
Registration Date:
Mode of Study:
Stage of Study:
I confirm that at present I AM able to proceed on my current programme.
Yes
No
If you have selected NO for the above statement and you cannot progress on your current programme at present you
are required to apply for an additional assessment opportunity through the Student Academic Appeal Procedures.
Please visit http://www.hw.ac.uk/registry/appeals.htm for further information.
Course Details (please complete ALL fields for each course)
I request an additional assessment opportunity in the following courses:
Code
Title
Semester
Opportunity
Please provide details and reasons for the request e.g. why you were unsuccessful in previous attempts and why you
believe you should receive a further opportunity (no more than 500 words):
List supporting evidence attached e.g. medical note/certificate (If you do not have an electronic copy of the supporting
evidence you should submit hard copies to the School Administration Office):
Student Declaration: I agree with this application for an additional assessment opportunity and if it is approved, will abide by its
conditions.
**Signature of Student:
Date:
**If you are unable to submit an electronic image of your signature, please type your name above. The University will
consider the receipt of this form electronically, direct from your University email account, as being equivalent to a
signature.
PLEASE SAVE WITH FILENAME: ERO_Your Family Name, First Name Initial e.g ERO_Smith, J
Please email the completed form to your School/Institute Administration office from your Heriot-Watt email account
Section 2: School Comment
To be completed by Supervisor or Programme Director
This form should be typed and submitted electronically
Name of Staff Member:
Position:
Please provide a statement detailing your support, or otherwise, to permit an additional assessment opportunity
requested:
Please give details of the suggested progression route(s) available to the student:
I confirm that the student is able to proceed on the programme if I their application for
an additional assessment opportunity is unsuccessful.
**Signature:
Yes
No
Date:
**If you are unable to submit an electronic image of your signature, please type your name above. The University will
consider the receipt of this form electronically, direct from your University email account, as being equivalent to a
signature.
Section 3: School Authorisation
To be completed by the School Director of Learning and Teaching
**Signature:
Date:
**If you are unable to submit an electronic image of your signature, please type your name above. The University will
consider the receipt of this form electronically, direct from your University email account, as being equivalent to a
signature.
*Please email this completed form to [email protected]. If you are unable to send supporting evidence
electronically please email this form and send medical evidence via the internal mail with this form as a
coversheet to Academic Registry.
SAVE FILE AS: ERO_Student's Family Name, First Name Initial e.g ERO_Smith, J
Section 4: USC/PSC Authorisation
To be completed by the Chair of the Undergraduate/Postgraduate Studies Committee
Approved
Comments/Conditions
Not Approved
Approved
subject to
conditions
Signature of Chair:
Date:
Academic Registry, October 2013
