This form should be submitted to the Curriculum Dean through the subject teacher, and returned to the student through the subject teacher. The form should be attached to the student’s submission and kept in the student’s subject folio.

ASSIGNMENT EXTENSION FORM - Years 7 - 10 Holy Spirit College

Subject Area : _________________________________________________Student Application Extensions should be sought before due date and should be supported with documentary evidence and drafts as outlined below. If this

application is submitted on the due date the student should be prepared to submit progress to date, pending approval of this

application.

Student Name: ___________________________________________ Year Level/Contact Group: ______________

Teacher: _____________________ Assignment Type/Description: _______________________________________________

Date of Request: _______________ Assignment Due Date: ______________ Draft submitted: Yes No

Student’s Signature: _________________________________ Requested New Submission Date: ______________

Parent/Guardian Declaration

Holy Spirit College’s Assignment Extension policy seeks to create and maintain just outcomes for students to complete assignments. Whilst

consideration and compassion are extended to students who have ongoing and unexpected issues which seriously impact their ability to

complete assignments in given timelines, it is important that these issues are verified and students who meet deadlines are not disadvantaged

by other students receiving extensions without due consideration.

Please indicate the reason below that best describes the nature of the extension request and attach supporting

documents. Note: Part time work commitments are not generally considered for extension applications.

(Notes may be written in the space provided below the table.)

Long term or short term medical issueMedical Certificate attached? Yes / No

Significant family or personal issuesNote from (please circle) Parent / Counsellor / Year Coordinator

Extended sporting or cultural representationDocuments / Note attached? Yes / No

Other (Please provide a basic overview below.)

Please provide any relevant information to assist with this application.

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Parent’s/Guardian’s Signature: ________________________________________ Contact No: _______________________

Teacher Recommendation

Draft SightedMinimal Progress __________________________________________ Final Draft Standard

(Please mark the continuum to indicate standard/progress of drafting.)

Recommendation for ExtensionNot Recommended __________________________________________ Full Recommendation

(Please mark the continuum to indicate strength of recommendation.)

Suggested New Submission Date: ______________

Teacher’s Signature: _________________________ Date : ___________

Curriculum Dean Decision

Extension Granted: Yes No

Curriculum Dean’s Signature: _______________________________

New Submission Date: _______________

Last Updated 25/2/2020