Declaration of Extenuating
Circumstances Form
Submit two completed copies of this form to your professor (or lab instructor) with supporting documentation, if needed
(see reverse). Upon review, your professor will return one to you and submit the other to the Science Advising Centre.
In signing this form, you acknowledge your awareness of the general Faculty of Science guidelines related to missed
academic work due to extenuating circumstances (included on back of this form), as well as your awareness of the
‘Academic Integrity and Students Responsibility’ section of the Saint Mary’s University Undergraduate Academic Calendar
Student Information:
Last Name:
First Name:
Student #:
Phone Number:
Current Program:
Current Semester:
Date of Missed or Late Academic Requirement
Type of Missed or Late Academic Requirement
Reason for Request:
Student’s Signature:
Approval Granted:
Yes No
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Declaration of Extenuating
Circumstances Form
Faculty of Science Student Absence Guidelines
Student Absence and Missed Requirements in Faculty of Science Courses Guidelines
Students who have Extenuating Circumstances during the regular term may submit the attached form (hard
copy in duplicate or scanned) as a request for academic exception to their lab or course instructor. Exceptions,
based on legitimate extenuating circumstances MAY be granted at the discretion of the instructors. For clarity
on what constitutes legitimate extenuating circumstances, students may ask a science advisor or their course
The following are two common scenarios for which these Guidelines are relevant:
Scenario 1: A Student EXPECTS TO miss an exam, presentation or assignment:
o The student must contact the instructor 72 hours BEFORE the date. Depending on the
situation, the student will submit the Declaration Form prior to the missed requirements or within
72 hours after the missed requirement.
o For situations when a student knows of a conflicting event long in advance (e.g., SMU varsity
athletic competition or other SMU-sponsored/related activity, other high/national-level
acurricular event, religious/holy-day observance), the form should be submitted within one
week of the announcement of the test/presentation date (in alignment with Academic
Regulation 8g).
Scenario 2: A student unexpectedly MISSES an exam, presentation or assignment
o The student must contact the instructor within 48 hours AFTER the date at issue, and submit
the form.
Once an exam/test is written, it “counts”; after-the-fact appeals to change a grade can only be made through
an official Appeal of Grade after the course is completed (see
If a student does not wish to relate the nature of extenuating circumstances to their course instructor or if the
circumstance affects multiple Science courses, the student may discuss their situation with a Science Advisor
at the Science Advising Centre (AT 301; email and have the Advisor contact the
Supporting Documentation: Students should not go to a physician SOLELY to obtain supporting
documentation to validate one-time missed classes/labs/tests. Students may be asked to provide appropriate
supporting documentation for circumstances such as:
Long-term illness or injury or evidence of ongoing treatment (e.g., certified by documentation from a
licensed health professional).
Recent death or life-threatening illness or injury of a family member or close friend (e.g., death
certificate, published obituary; certified by documentation from a licensed health professional).
Note that if any such documentation is determined to be fraudulent, or if the signed Declaration of
circumstances is found fraudulent, this will be considered an academic offence and will be investigated
as outlined in the 'Academic Integrity and Student Responsibility' section of the Undergraduate
Academic Calendar.