Mbs Special Circumstances Template

Manchester Business School Undergraduate Services Special Circumstances Form This form should be completed when a student is unable to attend any of their classes – seminars, workshops or lectures – because of illness or other good reason. Introductory notes:

1)

If you have advance notice of an absence (e.g. funeral of a close relative) you should inform the Course Unit Coordinator of the class(es) you will miss before the lecture, seminar or workshop. You must also complete a Special Circumstances Form prior to your absence(s) and hand it in to your Programme Office.

2)

If you are absent due to illness or other unforeseen circumstances you must complete a Special Circumstances Form within one week of the absence(s). Forms submitted to the Programme Office later than one week after the absence will be held on your file. However, except in the case of prolonged absence for medical or other reasons of a serious nature, you will be considered as having been absent without authorisation. Your Programme Handbook gives full details of the action taken in response to absences and you are strongly advised to familiarise yourself with the penalties for unsatisfactory attendance.

3)

The information given in this form is confidential although you are asked to consent to the details being disclosed to University of Manchester personnel, including the MBS Board of Examiners, having a need to see them in the course of their work.

When the form is completed, you must SUBMIT IT with any additional documentation to your Programme Office at the Singapore Institute of Management. Inform the Programme Officer and deposit the documents in the BSMGT Assignment Box on level 2. Personal Details Enrolment Number

Family name Other names Degree Programme Year of programme

Enter 2 or 3.

Name of your personal tutor Contact telephone number and email address

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Absence details Date of absence

Time of lecture seminar / workshop

/

Course unit code Course unit title Course unit Coordinator Seminar/Workshop leader (if not the Unit Coordinator)

Reasons for Lecture/Workshop/Seminar Absence

Please describe, in full in your own words, the reason for your absence(s) and attach any relevant supporting information). If the absence is due to illness you must also complete a ‘Certificate of Student Ill Health’ and attach it to this form.

Student declaration and consent I confirm that the information I have given is correct to the best of my knowledge. I consent: 1)

to this document and supporting evidence being recorded on my manual file;

2)

to the details being recorded on any electronic file relating to my performance in assessment; and

3)

to the details being disclosed to University of Manchester personnel, including the MBS Board of Examiners, having a need to see them in the course of their work.

Signed:__________________________________________Date:______________________

For office use only: Received and Recorded by Programme Office

Form received within one week of absence YES / NO

Second consecutive absence

Action taken

YES / NO

Initials

Initials

Date

Date

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