The College responsible means College office for undergraduate students. For postgraduate coursework students this means the College office or
the academic area responsible for your program.
A deferred examination is the sitting of an examination at a time other than the scheduled date/time. Wherever possible a student should sit their
examination at the prescribed time, and if necessary apply for special consideration for the marking of the examination. Deferred examinations are for
students who are unable to attend the examination at the prescribed time.
For more information on Deferred Examinations, please access the Student Assessment (Coursework) Policy: https://policies.anu.edu.au/ppl/index.htm
and the Assessment Rules: http://www.anu.edu.au/about/governance/legislation
Full name
This form is only to be used in relation to formal sit down examination(s) where circumstances have prevented or will prevent the applicant from sitting that examination(s)
Courses for which a Deferred Examination is sought:
Ensure that you attach separate supporting documentation from any relevant independent person or authority including health professionals
Due Date
Course Title for affected course
Course Code
College Responsible*
Application for Deferred Examination(s)
You must use
Adobe Acrobat Reader to
complete the form.
Please DO NOT print it
out and fill it in by hand.
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Summary of Application:
Please summarise the reason/s for your application in a SHUVRQDOstatement and attach it to this form.
Additional information or documentsIURPDQLQGHSHQGDQWDXWKRULW\, ZKLFKsupport 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
A Medical Practitoner's Form can be found here: http://www.anu.edu.au/files/resource/Application%20for%20Deferred%20Examination%20Supporting%
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
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:
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Attach evidence & submit (email)
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