ST MARY STAR OF THE SEA COLLEGE ILLNESS/MISADVENTURE APPEAL 2011 I, ………………………………………………………………, of YEAR ………Tutor Group ……… (PLEASE PRINT)
was unable to attend/hand in the following assessment task/exam or was late on the day of an assessment task because of (PLEASE INSERT REASONS) ……………………………………………………………………………………………………………… ………………………………………… DATE OF RETURN TO SCHOOL : ………………………………… All sections of this form must be completed before it is returned to Mrs Halcrow within 5 days of the task or your return to school. TO BE COMPLETED BY STUDENT, THEN DECISION MADE AND SIGNED BY SUBJECT COORDINATOR :
SUBJECT
CLASS TEACHER
TASK/EXAM
DATE OF TASK
COORDINATOR’S DECISION AND SIGNATURE
DATE OF ALT. TASK OR EXTENSION(if applicable)
This appeal must be supported by documentary evidence e.g., a doctor’s certificate. Signature of student …………………………………………… Signature of parent/guardian ………………………………….. Date : ………………………… ************************************************************************************************
Year Coordinator’s Signature : ………………………………… Academic Care Coordinator’s Comment and Signature : ……………………………………………………………………………………………………………… ……………………………………………………………………………………………………………… Date Received : ………………… APPEAL :
UPHELD
DENIED P.Halcrow
P.Halcrow