GCSE, A Level and BTEC Mitigating Circumstances Form

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Should you wish to raise a concern about the selected sources of evidence, this form must be completed by Wednesday 12 May 2021.
Should you wish to raise a concern about your performance in assessments due to personal circumstances, this form must be completed by Friday 21 May 2021.

First Name *

Surname *

Tutor Group *

I believe I have not had the opportunity to learn the content being assessed in the identified sources of evidence, having missed both the initial teaching and revision lessons. *

Yes

Required

If the answer is Yes, please provide full details below including the Subject and a list of the content you believe you have not learnt.

I have had an injury or illness at the time of the selected assessments that may have had a negative impact on my performance. *

Yes

Required

If the answers is Yes, please provide details below.

I have suffered a bereavement or traumatic experience that may have had a negative impact on my performance in the selected assessments. *

Yes

Required

If the answer is Yes, please provide details below.

If there is any additional information the School should be aware of, please provide details below.

Submit

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