Long Term Academic Considerations for Coursework

As per the Academic Consideration Policy, if students encounter extenuating circumstances that temporarily hinder their capacity to fulfill in-class academic requirements for a period that exceeds five days, they can request academic consideration as per the following instructions:

Consult the course syllabus about the instructor’s policy or procedures for requesting academic consideration
Contact your instructor(s) as soon as possible and normally no later than 24 hours after the submission deadline.
If supporting documentation is requested by your instructor, upload the appropriate documentation to this form.
Complete and submit course work per academic consideration, if granted.

Extenuating circumstances are circumstances that:

are beyond a student’s control
have a significant impact on the student’s capacity to meet their academic obligations; and
could not have reasonably been prevented

Long Term Academic Considerations for Coursework Form

Student Name(Required)

First Last

Student Number(Required)

Carleton Email Address(Required)

Phone Number

Nature of Extenuating Circumstance(Required)

List the impacted course(s) including course code and section (ex: PSYC 1001A)(Required)

Coursework requiring academic consideration(Required)

Coursework Deadline(Required)

Instructor Name(Required)

First Last

Instructor Email(Required)

Enter Email Confirm Email

Declaration

Please read and check each box:(Required)

I certify that I missed/will miss the scheduled course component(s) listed above. I understand and acknowledge that providing false or misleading information in order to avoid or delay the submission of work or to avoid an exam is a violation of section VI.4 of the Academic Integrity Policy and is subject to an Academic Integrity review.

I understand that deferring the course components listed above may result in a negative impact to my academic performance. I will consult with an academic advisor as needed and be sure that I am aware of the academic withdrawal deadline and, as always, assess my continuation in my courses before that deadline.

I certify that I have read all of the above information and followed all of the steps indicated.

I certify that I have attached the supporting documentation as requested by my instructor.

I understand that by completing and submitting a Long Term Academic Consideration for Coursework Form I am authorizing the Registrar’s Office to contact those who have provided documentation submitted with my application, including but not limited to medical documentation, for purposes of verifying authenticity.

Type your full name in lieu of a signature

Date

If you have any questions regarding your academic consideration request, please contact your instructor. The course instructor will determine any academic consideration for all in-class academic deliverables excluding formally scheduled and take-home undergraduate final exams. Undergraduate students that require accommodations for final examinations must follow the Deferral application process.

Upload your supporting documentation

Drop files here or

Accepted file types: pdf, doc, docx, , Max. file size: 15 MB.

Additional Comments

CAPTCHA