Variation Request

Request for Variation to Scheduled Professional Experience

Required fields are marked with an asterisk (*).

To apply for a variation to scheduled professional experience please complete this form and attach supporting documentation as relevant.

First Name *:

Surname *:

Student ID *:

University Email *:

Course *:

Unit *:

Reason *:

Proposed New
Placement Date*:

Day Month Year

Prior to applying for a Variation please read the Professional Experience Guidelines carefully.

Reason for Variation*:

Upload any supporting documentation:

STUDENT DECLARATION

I, confirm that I have read the above information and understand the guidelines under which my application will be assessed. I have included with my application appropriate supporting documentation. I authorise the University to seek such additional information as may be required.

Once you have checked that everything is correct, please check the box below agreeing to the content of this form and then press the Submit button.

I Agree *

Once you submit this form you will see a confirmation screen and receive an email to confirm the details you have entered. If you do not see the confirmation screen, or do not receive the confirmation email within 24 hours, then please contact the Professional Experience team immediately.

NOTES:

By submitting this form electronically I, the student, agree to the following declaration:
This is a true and correct account of my signature and will be deemed a legal and binding signature.
The Faculty cannot guarantee the requested dates or locations as there are other scheduled practicums at this time. Thus, where possible you should be prepared for alternative dates (within reason) and some travel (within reason).
Any decision is final and no correspondence will be entered into.