EAP12(part b)

Supporting Evidence for Alternative Examination Arrangements due to a Specific Learning Difficulty (SpLD)

This form is for applications for exam adjustments for candidates with a SpLD only and should accompany form EAP12 (part a). ~Sections A, B and C should be completed by the Disability Advisory Service and returned to the student’s College. The College should then complete section D.

Section A: Student Details

Name of College:
Full name of Student / Surname: / Forename(s):

Section B: Recommended Examination Adjustments (To be completed by the Disability Advisory Service)

Diagnosis
Extra writing time
(Please tick one option) / None / 5 mins/hr / 10 mins/hr / 15 mins/hr / Other (please specify)
Rest time (to be taken at the candidate’s discretion. Please tick one option)
This will require the candidate to sit exams in College. / None / 5 mins/hr / 10 mins/hr / 15 mins/hr / Other (please specify)
Is a College sitting required for written examinations? / Yes / No / If yes, please indicate why this is necessary.
Use of a word processor? / Yes / No
Any other adjustments?
Comments

Section C: DAS declaration

DAS declaration:
I confirm that the diagnostic evidence submitted by this candidate sufficiently supports the diagnostic conclusion of a specific learning difficulty and meets the Proctors’ guidelines for suitable evidence for examination adjustments.
Signature of SpLD Specialist or Chartered Psychologist (an electronic signature is acceptable)
Date:

Section D: Further Details (to be completed by the student’s college)

If a word processor is recommended for use in examinations, are there any papers that the candidate would wish to handwrite?
If yes, please give details below: / Yes/No
Recommendations for any non-written examinations e.g. oral / practical / musical recital etc.
If yes, please give details below:
Please note that any adjustments approved for written examinations may not be appropriate for non-written examinations, and will not be automatically applied. Requests for adjustments for non-written examinations should be discussed with departments directly to ensure they are workable prior to completing this section of the form. Please also be aware that some examinations are not administered by the examinations and assessments team and colleges should liaise directly with the departments concerned to ensure that approved adjustments are in place prior to the examination session. / Yes/No

Once complete this form should be scanned and sent together with form EAP12 (part a) to the Examinations and Assessment Team:

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