Reasonable Adjustment Form for Corporate and
Professional Qualifications
It is important to us that all our students have the opportunity to demonstrate their true level of ability during an assessment.
To make an application, please read the Reasonable Adjustments Policy and Procedure for Corporate & Professional Qualifications and then
email your completed form, together with supporting evidence, at least 8 weeks prior to the date when your adjustment will need to be in place.
We may not be able to apply your adjustment if received after this deadline.
The London Institute of Banking & Finance is a registered charity, incorporated by Royal Charter.
YOUR DETAILS
LIBF number (If known) ____________________________________________________ Title (Mr/Mrs/Ms etc) _____________________________________________
First name(s) / Given name(s) ____________________________________________________________________________________________
Last name / Family name _______________________________________________________________________________________________
Date of birth*
(DD/MM/YYYY) ____________________________________________________ Gender Male
n
Female
n
*A date of birth is compulsory to activate your online account.
YOUR DETAILS
YOUR DETAILS
Email address* _______________________________________________________________________________________________________________________
Please provide a telephone number we can use to contact you if necessary:
Telephone no. ______________________________________________ Mobile no.
(if different from Telephone no.) _________________________________________
*Please note that having a valid email address is a compulsory requirement of study.
CONTACT DETAILS
YOUR DETAILS
Business address
________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
Postcode / Zipcode
_____________________________________________________ Country _____________________________________________________
Home address ________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________
Postcode / Zipcode
_____________________________________________________ Country _____________________________________________________
Please indicate which address you would prefer us to use for postal correspondence: Business
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Home
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ADDRESS DETAILS
PLEASE TICK THE BOXES THAT YOU FEEL BEST DESCRIBE YOU
n
You have a social / communication impairment such as Aspergers syndrome
n
You are blind or have a serious visual impairment
n
You are deaf or have a serious hearing impairment
n
You have a long standing illness or health condition such as cancer, HIV or epilepsy
n
You have a mental health condition, such as depression or anxiety disorder
n
You have a specific learning difficulty such as dyslexia, dyspraxia or ADHD
n
You have a physical impairment or mobility issues
n
You have a disability, impairment or medical condition that is not listed above
We require a statement from a medical professional that confirms the nature of your disability eg Doctor’s or Consultant’s letter,
Educational Pyschologist's or Specialist Teacher's Assessment report. If you are unsure what documents to send please contact us for
further advice. We may request further supporting evidence and in all cases, you should only send photocopies or scans as we are unable
to return original documents
Is this a permanent impairment? Yes
n
No
n
Please give any additional information below that you feel may be relevant:
