This form is to be completed if you are requesting a Withdrawal with Special Circumstances from either your course or some units of study. Please ensure you refer to the Withdrawal Policy and Procedure before completing the form.
This form is to be completed if you are requesting a Withdrawal with Special Circumstances from either your course or some units of study. Please ensure you refer to the Withdrawal Policy and Procedure before completing the form.

Personal Details:

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Special Circumstances

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Support Documentation:

To support your case further documentation should be provided and attached: *
 




Signature *
clear
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Version 2.2