Coventry University London

ATTENDANCE WITHDRAWAL APPEAL REQUEST FORM

To appeal the decision of your attendance withdrawal you are required to read the following guidance:

  • Academic Regulations:
  • Attendance Monitoring:
  1. STUDENT DETAILS:

Student ID Number
Family name
Forename(s)
University email address
Programme Title (e.g. MBA Global Business)
Year of Study (1, 2, 3, etc.)
  1. I AM REQUESTING TO APPEAL AGAINST MY ATTENDANCE WITHDRAWAL DUE TO THE FOLLOWING:

Medical problem (illness or serious accident)
Recent death of a close relative
Serious illness of a close relative
Serious problem at home
Victim of crime
Serious personal matters
Housing problems
Natural or environmental
Transport issues
Administrative error
  1. GROUNDS FOR APPEAL

Please give full details of your grounds for appeal, attaching further sheets if required. All supporting documentation (e.g. medical or other evidence of impairment) must be attached to this form and submitted to

Please state clearly the grounds of your appeal and why these extenuating circumstances were not disclosed before your withdrawal from the university
  1. EVIDENCE

Your appeal should be supported by relevant documentary evidence. For example, if you are citing a medical problem, you should submit a medical report as confirmation. Please list the evidence submitted below.

The evidence should provide an indication of the degree of impairment suffered, as well as stating as clearly as possible how the period of extenuating circumstance relates to, and impacted upon, your attendance.Please note that where your evidence is in a foreign language it is your responsibility to ensure that you obtain a certified translation into English before submission.

It is your responsibility to provide supporting evidence, and to decide what should be included

(Examples: prescriptions, medical certificate, hospital admission/A&E record, letter from legal, medical or counselling professional, Police crime reference number, student loan/debt letter, tenancy agreement, independent witness report, death certificate, letter from welfare and disabilities office, newspaper/media report, transport company letter, Met Office report, letter from employer. Please note, all medical evidence submitted must be from a UK General Medical Council registered medical professional)
  1. OUTCOME REQUESTED

Please state what you would like to see as the outcome of your appeal
  1. DECLARATION

I confirm that the information given in this form and in supporting documents is true to the best of my knowledge and belief.

Student Signature / Date
For appeal requests against decisions made by the Campus Registrar, the studentmust submit the Attendance Withdrawal Appeal Request Form, with full supporting documentation to thinten working days from (and excluding) the date of withdrawal letter.

August 20171