special consideration form (1) (1)

8/11/2019 Special Consideration Form (1) (1)

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Web Form Appeals for Special Consideration

You should fill this form in and submit [email protected] related

supporting documentation, if you wish to make an application for special consideration inyour November 2013CIMA exams.

Please note that any applications that are receied after the deadline of 2t!"ecember will

not be accepted.

You should read the CIMA policy on !"erms and conditions for appeals for special

consideration#$ aailable from the CIMA website %www.cimaglobal.com&.

'ull (ame

CIMA Contact I)

*xams that you wish tohae +pecialConsideration for

*xam centre details (ame of Centre,Colombo additional centre.

Address of Centre,

(o -/$ *litigala Mawatha$

Colombo 0$ +ri 1anka.

Please state whether your application is based on %tick box which is applicable&,

2. Personal temporary indisposition$

3. Illness or bereavement of a family member$

-. A problem at your exam centre

If your consideration relates to a medical condition please tick box if you are supplying

supporting medical documentation with this application %scanned electronic documentsare acceptable&,
mailto:[email protected]:[email protected]://www.cimaglobal.com/mailto:[email protected]://www.cimaglobal.com/


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'urther Information in support of your appeal re4uest,

Please proide more details in this section relating to the aboe stated specialconsideration re4uest. It is the appellant#s responsibility to gie all the re4uiredinformation. 'ailure to gie ade4uate details or supporting eidence may affect theoutcome of your appeal. You may continue on additional pages if appropriate. You shouldproide details$ as appropriate$ under one of the following categories %A$ 5 or C&,

A# $our %edical Conditioni. "he nature of your conditionii. 6hen did it commenceiii. )etails of the medical or specialist adice sought.i. )id the condition7 illness exist at the time of the examination under

consideration here8

$our personal circumstance's(9 which you claim has had an aderse effect onyour exam performance

i. "he nature of the circumstanceii. 6hen it aroseiii. :ow this has affected you.

C# )roblem *it! t!e e+am centre

i. 6hat was the problemii. 6hen did it commenceiii. 6as it reported to the *xam +uperisori. 6hat adice7action was taken by the *xam +uperisor

Please identify your situation from options A$ 5 or C aboe and use the space below tofully explain your reasons for applying for +pecial Consideration. Please ensure that youinclude the information re4uested in the subheadings gien aboe %continue onto anotherpage as necessary&,

;ption A

A week before the exam I was diagnosed with iral feer$ sore throat and cough and wasadised to rest but again on 2


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"eclaration b student-

I understand that a successful appeal for special consideration can only result ina small ad=ustment to my oerall mark. I also accept that the decision of the Appeals

6orking Party is final and that CIMA cannot enter into any further correspondence about my

application.

Please tick this box to indicate that you accept these terms %Appeals for special

consideration cannot be accepted if this box is not ticked&

special consideration form (1) (1)

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