Psychology extension request form

All requests for extensions for work in Psychology Courses MUST be:

Submitted using this form.
Accompanied by formal documentation (e.g., medical certificate, police report).
Submitted prior to the official due date and time.

If you request an extension without meeting these conditions, you will be redirected to follow them prior to consideration of your request.

NOTE: Extensions are not granted automatically; simply completing and submitting this form does not guarantee that you will receive an extension. Also, the Research School of Psychology does not treat EAPs as automatic extensions; students with EAPs must still submit this form if they seek an extension.

If you have any questions please contact the Psychology Office 1st floor, Building 39 on University Ave or 6125 2796, or email: enquiries.psychology@anu.edu.au

Personal details

Name

U-number

Contact number

Are you currently registered with ANU Access and Inclusion?

Yes

Information about this assignment and the circumstances of your request

Course

Assignment

Please indicate the assignment for which you are requesting an extension.

Assignment date

Please indicate the original due date for this assignment.

Date of difficulties

Indicate the date (or approximate date) on which your current difficulties began.

Extension length

What is the length of the extension you are requesting (i.e., how many additional days/hours extra are you seeking)?

Have you discussed with your tutor or the Course Convenor the difficulties you have been having prior to requesting this extension?

Yes

Discussion outcome

Have you requested an extension for any assignment in any other course during this current semester?

Yes

By providing this information it will help us to best support you over the course of the semester. This will assist the convener to properly assess your situation to ensure you receive the best outcome.

Please specify what courses

Reason for your request

Please indicate the reasons for your request

Supporting documentation

Supporting documents (e.g., medical certificate, police report, EAP)

Maximum 5 files.
5 MB limit.
Allowed types: pdf, doc, docx.

Copies of drafts/notes of the work on this assignment that you have completed already

This information will help us to understand how far you have progressed on the assignment and the length of the extension required.
Maximum 5 files.
5 MB limit.
Allowed types: pdf, doc, docx.

If you have not included copies of drafts/notes of the work on this assignment that you have completed already, provide an explanation for not doing so

Confirmation of accuracy

I confirm that all information that I have provided in this Extension Request Form is accurate to the best of my knowledge, and that I am willing to discuss this matter further in person either with the relevant course convenor or with another nominated representative of ANU.

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School of Medicine and Psychology
ANU College of Health and Medicine

Psychology extension request form

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