ࡱ> ?P>e bjbjqq ;&p\p\ t t <<<PPP8,,PTf("1E $p"J<Q@QQCCCQF8<CQCC$C0ڞ{XC$0TC""C"<C|QQCQQQQQ<QQQTQQQQ"QQQQQQQQQt > :  CONFIDENTIAL APPENDIX A Medical Certificate for Candidates Requesting Additional Examination Arrangements In order to ensure that comparable consideration may be given to each request for additional examination arrangements, it would be greatly appreciated if Doctors asked to support such requests could complete the standard form below. Academic Departments should then return this to the Registry. Students Name:................................................................................................................. Department:............................................................................................................... CID number: ...................................................................................... Subject: ........................................................................................................ This student has been suffering from: ........................................................................................................................... (Illness) Since .............................................................. (date) It is not standard practice to have both extra time and rest breaks, unless in exceptional circumstances. He/she will be assisted by the following additional arrangements during the examinations (if extra time / rest breaks are requested, please specify the amount of time which would be appropriate and indicate how this will help the candidate): any special arrangements should compensate for the candidates disability only and not relatively disadvantage other candidates. This condition is likely to affect his/her performance in the examinations in the following manner: These arrangements will need to be reviewed (please tick):  FORMCHECKBOX  For each set of exams (please specify date)  FORMCHECKBOX  Annually  FORMCHECKBOX  Permanent Arrangement Signed:...........................................................................Date:........................................... 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