EXTENSION REQUEST FORM
This extension request form is for those seeking an extension on their assessment work. Our heart is to help each and every person where possible. If we can help you by being flexible with assessments we would like to do so. Please help us by requesting an extension before the due date. Refer to the
student handbook for our extension policy.
If you have any questions about completing this form please
Course / subject name
For example: 'Intimacy with God' or 'Identity', etc.
Assessment Task Number
E.g. Task 1
Requested length of extension
E.g. two weeks
Requested new date
Reason for extension
Please attach evidence when appropriate (e.g. doctors certificate)
I declare that information provided in this form is to the best of my knowledge accurate in all respects.
Yes, I agree with this statement
Office Use Only:
Date Received: ___/___/_____
Extension Granted? YES / NO
New Due Date:
___ / ___ / _____
Comments: _______________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________
Student informed: YES / NO
Director of Studies signature: ____________________________________ Date: ___ / ___ / _____
Submit Extension Request Form