Special Consideration Application Form
Applications to be made within 5 working days of the examination date.
For further information regarding special consideration requirements please refer to the Special Consideration policy available online here.
Please return this form to fcexams@libf.ac.uk
The London Institute of Banking & Finance is a registered charity, incorporated by Royal Charter.
Y
OUR DETAILS
Centre name ____________________________________________________________________________________________________________________________________
Student name _____________________________________________________________________ LIBF number ______________________________________________
SECTION 1 LEARNER DETAILS
YOUR DETAILS
Qualification ________________________________________________________________________________________________ Unit ______________________________
LIBF e-test
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Yes or Exam Session Number __________________________________ Exam Date _________________ _________________________
SECTION 2 EXAMINATION DETAILS
Y
OUR DETAILS
Please give all the relevant details for requesting special consideration of the above examination.
Please also confirm if the student completed the exam, did not finish the exam or was not present.
SECTION 3 SPECIAL CONSIDERATION DETAILS
YOUR DETAILS
We will use and protect your personal data in accordance with current data protection legislation to evaluate your claim. Further details,
including your rights, the disclosure of data to third parties, storage, retention and how to amend your personal data, can be found within
our Privacy Notice (www.libf.ac.uk/privacy)
SECTION 4 YOUR PERSONAL DATA
YOUR DETAILS
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I declare that the information contained in this form is true and accurate and consent to the processing and use of personal data as
outlined in the Privacy Notice.
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I confirm that by completing and submitting this form and associated evidence, I give consent to the processing and secure storing of
the evidence provided.
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I confirm that I have read and understood the Special Consideration Policy.
Examinations Officer Signature _______________________________________________________________________ Date ___________________________________
SECTION 5 DECLARATION
LC07/19
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signature
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