Appeal Form (Research Students)

CONFIDENTIAL

Birkbeck, University of London

APPEAL FORM (RESEARCH STUDENTS)

To be eligible to make an appeal under the Appeals Policy and Procedure (Research) you must be registered on a research degree at Birkbeck.

You should attempt to resolve your appeal informally by discussing it with your supervisor, research director, administrator or other appropriate member of staff in your department, before making a formal appeal.

If you intend to make a formal appeal against a decision made by a board of examiners, you must use this form to put forward your case. You are required to complete all sections. You should expect acknowledgement within 7 days and will be informed of the outcome of your appeal in due course.

This form should be sent to or be handed in at the Student Centre in the main Malet Street building. Please note that all appeals must be made within 6 weeks of notification of the results.

SECTION A - YOUR DETAILS

Title..….…………… Full Name ………………………….....……………………………………………..

Address…………………………………………………………………………………………………………………..

..………………………………………………………………………………………………………………..…………..

…………………………………………………………………………………………………………………………………

Postcode ………………………………… Tel No……………………………………………………………….

Email……………………………………………………………………………………………………………………..

Programme of Study …………………………………………………………………..……………………..

Student Number ………….…………...………………………………………………………………………….

SECTION B – NATURE OF THE APPEAL

Grounds on which you are appealing:

a)You have undisclosed mitigating circumstances

b)The examination was not conducted in accordance
with the regulations

c)The assessment or assessment decision was not conducted in
accordance with the relevant policies

Date on which you were notified of the result you are appealing against: ......

Please outline the details of the appeal in the box below.

PLEASE LIST ANY DOCUMENTARY EVIDENCE ATTACHED AND MAKE SURE YOU KEEP A COPY: (eg any correspondence, list of dates when events occurred, or other documentation related to your appeal)

SECTION C – AN OUTLINE OF THE ACTION YOU HAVE TAKEN SO FAR

Please outline the steps you have already taken to resolve your appeal informally:

Who did you contact about your appeal? ………………………………………………………………

Position…………………………………………………………………………………………………………………….

School/Department ………………………………………………………………………………………………..

Describe the outcome of any action taken so far and explain why you believe that the matter has not yet been resolved.

SECTION D – DECLARATION

I believe that the above information is accurate. I confirm that details of this appeal can be passed on to a case handler and the Chair of the Research Student Sub-Committee.

Signature:………………………………………………………………………………………………………………

Date:……………………………………………………………………………………………………………………….