Web Form Appeals for Special Consideration

You should fill this form in and submit to exams.consideration@cimaglobal.com with related
supporting documentation, if you wish to make an application for special consideration in
your November 2013 CIMA exams.
Please note that any applications that are receied after the deadline of 2
t!
"ecember will
not be accepted.
You should read the CIMA policy on !"erms and conditions for appeals for special
consideration#$ aailable from the CIMA website %www.cimaglobal.com&.
'ull (ame



CIMA Contact I)



*xams that you wish to
hae +pecial
Consideration for





*xam centre details (ame of Centre,
Colombo additional centre.

Address of Centre,

(o -./$
*litigala Mawatha$
Colombo 0.$
+ri 1anka.



Please state whether your application is based on %tick box which is applicable&,
2. Personal temporary indisposition$
3. Illness or bereavement of a family member$
-. A problem at your exam centre
If your consideration relates to a medical condition please tick box if you are supplying
supporting medical documentation with this application %scanned electronic documents
are acceptable&,
'urther Information in support of your appeal re4uest,
Please proide more details in this section relating to the aboe stated special
consideration re4uest. It is the appellant#s responsibility to gie all the re4uired
information. 'ailure to gie ade4uate details or supporting eidence may affect the
outcome of your appeal. You may continue on additional pages if appropriate. You should
proide details$ as appropriate$ under one of the following categories %A$ 5 or C&,
A# $our %edical Condition
i. "he nature of your condition
ii. 6hen did it commence
iii. )etails of the medical or specialist adice sought.
i. )id the condition7 illness exist at the time of the examination under
consideration here8
&# $our personal circumstance's( 9 which you claim has had an aderse effect on
your exam performance
i. "he nature of the circumstance
ii. 6hen it arose
iii. :ow this has affected you.
C# )roblem *it! t!e e+am centre
i. 6hat was the problem
ii. 6hen did it commence
iii. 6as it reported to the *xam +uperisor
i. 6hat adice7action was taken by the *xam +uperisor
Please identify your situation from options A$ 5 or C aboe and use the space below to
fully explain your reasons for applying for +pecial Consideration. Please ensure that you
include the information re4uested in the subheadings gien aboe %continue onto another
page as necessary&,
;ption A
A week before the exam I was diagnosed with iral feer$ sore throat and cough and was
adised to rest but again on 2<
th
(oember I had to seek medical attention because my
situation did not show any considerable improement.
I could not sit for the exam on the following day for the *2 paper but I managed to sit for
the exam on 30
th
for the P2 paper. My situation aggraated and unfortunately I was unable
to face the '2 paper on 32
st
(oember.




"eclaration b, student-
I understand that a successful appeal for special consideration can only result in
a small ad=ustment to my oerall mark. I also accept that the decision of the Appeals
6orking Party is final and that CIMA cannot enter into any further correspondence about my
application.
Please tick this box to indicate that you accept these terms %Appeals for special
consideration cannot be accepted if this box is not ticked&