EXAMINATION ACCESS ARRANGEMENTS REVIEW
Student Number:  
Surname:  
Forenames:  
Telephone Number:  
Email address:  
Examination Access Arrangements Currently Agreed with DDS

Examination Access Arrangements Requested 

Please give reasons for requested arrangements (please provide as much detail as you can – you may continue on another sheet, if necessary)

By signing this form you are agreeing that the Disability and Dyslexia Service can share this information with other College departments in order to facilitate your Examination Access Arrangements.  You may digitally sign this form.

Student Signature: 							Date: