BVCSC21 - Special Consideration - Bassingbourn Village College

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This form is to make us aware of circumstances which may be treated as special considerations as laid out by JCQ.

Please ensure that this form is filled in accurately and with as much detail as possible to enable us to follow the JCQ special consideration process.

An application being made does not mean that special consideration will automatically be applied. All applications will be checked against the JCQ guidance before the next steps in the process are taken.

Email *

Name of person filling out this form: *

Surname of Student: *

Forename of Student: *

Subject and specific assessment special consideration is being applied for (please use the historical evidence table which was attached to the original letter for correct titles, where appropriate) *

Below are a list of the main circumstances for which special consideration might be considered, where evidence is available. The special circumstance needs to be tied to a particular date in order to be applied for. Please indicate which of the below descriptions best fit: *

Terminal illness of an immediate family member or candidate

Death of an immediate family member within 2 months of the examination/assessment

Very serious crisis at the time of the assessment

Life threatening illness of the candidate or immediate family member

Major surgery at the time of assessment

Severe disease

Recent death of a member of the extended family

Recent illness or isolation

Recent death of a friend or relative

Recent physical assault

Recent flare-up of a severe medical/congenital or psychological condition

Illness during the assessment

Broken limb

Concussion

Anxiety or stress for which medication is prescribed

Other:

When did this circumstance occur? *

Please briefly describe the circumstance, e.g. if an illness, the duration and severity, which medication was taken: *

What evidence are you able to provide to support an application for this special circumstance? e.g. discharge letter from hospital, GP letter, photo of prescribed medication if currently taking it *

Are there more assessments for which you need to apply for special consideration? *

Yes

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