SPECIAL CONSIDERATION APPLICATION FORM

PERSONAL DETAILS

Student ID Number *

Family Name *

Given Name *

Mobile *

Email Address *

Address *

Course Name : *

HOW TO COMPLETE YOUR APPLICATION

To successfully submit your application, follow these steps:

1. Fill out the application form provided below and sign the declaration.
2. Provide ALL the necessary evidence (refer to the list below).

Please be aware that ASA will not proceed with processing this application until both of the above
steps have been completed and the application has been submitted. It is the responsibility of the applicant to provide evidence to prove that they have the acquired knowledge of the unit for which AS is being applied for.

Special Consideration is a provision available to students who encounter significant difficulties in meeting assessment requirements due to various circumstances. These circumstances include serious illness or injury, bereavement of close family members, major political upheaval or natural disasters in the home country, traumatic experiences, or any other compassionate or compelling reason supported by evidence. Students can apply for special consideration at any point during the study period. It's important to note that students do not need to wait until they miss a deadline to apply for special consideration. Applications must be lodged within five working days after the assessment task due date and before the end of the study period.

SPECIAL CONSIDERATION INFORMATION

Tutor Name

Unit Name:

Select the category for Special Consideration:

Enter other details *

Select Special Consideration Reason:

Health Related Matter

Loss or Bereavement

Hardship or Trauma

Other

Enter other details *

SUPPORTING DOCUMENTATION

Attach supporting documentation to support your Special Consideration request: Medical Certificate,
Statutory Declaration, a formal letter from an employer, a formal letter from a minister of religion or
other documents that will help to assess your request.

The supporting documents must clearly indicate:

Details of the circumstances
Impact on the student’s ability to complete assessment/exam
Duration of the circumstances (include start and end date)
Signature and contact number of an appropriate representative

Transcripts:

Subject/Unit descriptors :

Testamur(if applicable):

Course Structor if Not Australian Institution:

STUDENT DECLARATION

I declare that, to the best of my knowledge, the information provided in this form (and attachments) is accurate and comprehensive. I understand that incomplete information may lead to the return of my application. I acknowledge that it is my responsibility to furnish all required documentary evidence of my qualifications, and I confirm that the Official Statement of Academic Records supplied is an accurate record of my academic achievements.

Student's signature *

clear

Date * +