Extension Request Form
Extension Request Form
The form should be emailed to your module leader or nominated alternative no later than 24 hours
before the date/time that the assessment is due to be submitted, with the evidence attached.
Student information
Last name
First name
Student ID number
Programme information
Module information
Module code
Module name
Assessment component
Original deadline date
Reason for request
It is recommended that you password protect this form and any accompanying evidence when
submitting to your module leader/module tutor, as they may contain personal information.
Guidance on how to do this is provided in the Appendix to this form. Please remember to provide
the password to the module leader/tutor in a separate email.
1
Section B – module leader to complete
Module leader/tutor to complete and return to student. Please refer to the guidance in Appendix 3
of the academic regulations: dmu.ac.uk/scheme-regulations
If the extension is approved please ensure that the relevant assessment markers are informed in
order that the 20-working day turnaround for the provision of feedback can be adjusted to reflect
the revised deadline.