Application for Special Consideration Application for Special Considerations When to use this form Use this form when special consideration or arrangements are required due to unforeseen personal or compassionate circumstances but an assignment extension will not be sufficient. DO NOT use this form for a short extension on a due date. To apply for a standard assignment due date extension use the Application for Assignment Extension form instead. It will be quicker and easier! For more information see How to apply for an assignment extension or special consideration on myCMI. First Name * Family Name * Student Number * International Student * No Yes CMI Student Email Address Contact Number I REQUEST SPECIAL CONSIDERATION IN THE FOLLOWING SUBJECT(S) If you require special consideration for multiple units, please select 'add' below. Unit Code * Unit Title * Name of Unit Coordinator * Name of Assessment Piece (as per Unit Outline) * Due date of this assessment piece (as per Unit Outline) * Date of any extensions already approved, if applicable Date of requested special consideration extension, if applicable plus1 Add minus1 Remove TYPE OF CONSIDERATION Choose from below * Deferred Examination Supplementary Assessment Time Extension Other Date of original examination Date for re-examination Date for re-examination Other, please specify below GROUNDS FOR YOUR APPLICATION Refer to the TLP002-Assessment-Policy-And-Procedures Attach any relevant supporting documentation eg. Health Care Professional Certification (download here) in the case of a medical condition, police report or statutory declaration, etc. Indicate any specific requests in this section Choose from below * Medical Reasons Hardship/Trauma Loss or Bereavement Other Other, please specify below Please detail the reason(s) for application Additional Information (please provide information about how the event(s) have impacted on your studies and provide details of the specific request(s) you are making) Supporting Documentation Upload Here Choose File Maximum file size: 5MB Please note, if you are applying for Special Consideration on medical grounds, you do not need to provide specific details of a medical condition, but an appropriate Health Care Professional must complete the Health Care Professional certification which you must then upload here Please state the length of time (in days, weeks or months) your studies have been affected * I understand that without supplying appropriate supporting evidence, my special consideration request may be denied, or a decision may be delayed until appropriate evidence is provided. I understand that as per the CMI Assessment Procedure policy, it may take up to five (5) business days for me to receive a response from the Special Considerations Team. Submit If you are human, leave this field blank.