2 | THE AUSTRALIAN NATIONAL UNIVERSITY
Summary of Application:
Please summarise the reason/s for your application in a SHUVRQDOstatement and attach it to this form.
Additional information or documentsIURPDQLQGHSHQGDQWDXWKRULW\, ZKLFKsupport your application, must also be attached to your electronic submission.
It is a requirement that both a personal statement and independant supporting documentation is provided.
I have attached a separate personal statement summarising the reason/s for my application and attached it to the application (eg word document).
I have attached additional supporting documentation from an independent authority. Supporting documentation is in English or an official translation has been
provided.
A Medical Practitoner's Form can be found here: http://www.anu.edu.au/files/resource/Application%20for%20Deferred%20Examination%20Supporting%
20Documentation%20Form.pdf
Please select a reason for requesting a deferred examination from this list:
Special Examination Arrangements:
Do you have Special Examination Arrangements (changed examination conditions) for the courses listed on this form?
Same reason as above
Different reason to above
Yes
No
If yes, are they for:
I certify that the information supplied by me in this application is complete and true. I have read and understood the information about special
consideration provided in The Australian National University Assessment Rules 2014 (http://about.anu.edu.au/__documents/rules/
assessmentrules.pdf) and in the University’s Student Assessment (Coursework) Policy: (https://policies.anu.edu.au/ppl/document/ANUP_004603)
I acknowledge the onus is on me, the student, to provide evidence to substantiate my claim. Documentation lodged elsewhere for other purposes
will not be considered; all supporting documentation must be attached to this application.
Applicant Declaration:
Attach evidence & submit (email)