Examination Appeal Application

Please read this form carefully, complete it and upload the relevant documents.

The Examination Appeals Committee recognizes that you may wish to keep some of the factors which affected your performance confidential. However, the Committee is not in a position to make a decision unless it is in possession of the full facts and encourage you to give a complete account of all the circumstances which you feel impacted on your performance. This account will be treated with confidentiality.

Please be aware final year and exiting students that the conferring of a degree, where relevant may be deferred, pending the outcome of the appeal.

Important: Late applications will not be accepted under any circumstance. Ensure that you are aware of the application deadline for your results - available on the Examinations Office website.

Student Details

First Name*

Last Name*

Student ID Number*

Email* Email - Only University of Galway accounts e.g. EXAMPLE1@universityofgalway.ie accounts

Phone*

Examination / Module Details

Please list each module that you are appealing in the spaces provided below.

Note that a fee of 60.00 EUR applies to each module being appealed - Maximum fee of 300.00 EUR applies. Fees can be paid online only.

If appealing more than six modules, please list the additional Module Codes and Module Titles in the "Statement of Appeal" field

College*

Program*

Please insert the programme code in this field e.g. 1BA1, 5MB3

Exam Session*

Student Category*

Undergraduate Postgraduate

Module Title 1*

Please insert the module name in this field e.g. Principles of Physiology

Module Code 1*

Please insert the module code in this field e.g. AN123

Module Title 2

Please insert the module name in this field e.g. Principles of Physiology

Module Code 2

Please insert the module code in this field e.g. AN123

Module Title 3

Please insert the module name in this field e.g. Principles of Physiology

Module Code 3

Please insert the module code in this field e.g. AN123

Module Title 4

Please insert the module name in this field e.g. Principles of Physiology

Module Code 4

Please insert the module code in this field e.g. AN123

Module Title 5

Please insert the module name in this field e.g. Principles of Physiology

Module Code 5

Please insert the module code in this field e.g. AN123

Module Title 6

Please insert the module name in this field e.g. Principles of Physiology

Module Code 6

Please insert the module code in this field e.g. AN123

Grounds for Appeal*

A - If there is evidence of substantive irregularity in the conduct of the examination and / or the assessment process, or where a student presents evidence to support an assertion that the mark awarded was incorrect

B - If there are mitigating circumstances that impacted on the student\'s exam or assessment performance of which the Examinations Board were not aware when making its decision; or, the Examination Board were aware of the circumstances, however were not aware of the impact of those circumstances on the student\'s exam or assessment performance. If the mitigating circumstances had not been made known previously to the Dean of College as required at 4.2.1. QA235 Procedure for the Discussion Checking and Appeal of Examination Results, the appeal must include a support explanation for the non-disclosure. Where medical evidence is being relied upon, appropriate certification by an independent Medical Practitioner (exluding any Medical Practitioner who is a family relation) should be attached.

Please review FAQ https://www.universityofgalway.ie/exams/results/appeals/

Mitigating circumstances must be pertinent to the time of an assessment, and comprise (including but not limited to below):

Involvement in an accident or serious incident
An acute illness, injury, or trauma
Deterioration in an ongoing medical or health condition, or adverse change in a fluctuating condition
Life-threatening illness or death of a person with whom you have a close relationship
Significant adverse personal or family circumstances
Serious or abrupt upheaval, such as a house fire, burglary, or eviction; or upheaval with respect to geopolitical change related to period(s) of study abroad or international study trip(s)
A victim of crime or threatening behaviour
Other significant and relevant exceptional factors for which there is evidence that academic performance has been impaired.

If appealing under grounds B, did you in writing make known to the college Dean or nominated person, details of any mitigating circumstances as soon as possible but within two weeks of the examination or assessment. If no, please detail reasons below or in the typed statement of the appeal document to be uploaded. (Max of 300 words)

Statement of Appeal

Typed Statement of Appeal : A full description of what happened and why the appeal is being made * (Max of 300 words)

Supporting Document

Upload as one file any other appropriate, dated, documentation relating to the circumstances cited in your appeal e.g. expanded statement of appeal, medical evidence, correspondence, transcripts (this list is not exhaustive).

The Examination Appeals Committee recommends that applicants do not include original essays or theses with their appeal documentation. Applicants are advised that the committee can request additional documentation at a later stage, if the committee considers it relevant.

Important : Only one file can be attached to this form. If you have multiple documents or files, ensure that you combine them into a single file. A Zip file is not an acceptable format as it contains multiple files.

Upload Supporting Documents*

Choose File

Check List*

You must confirm you have checked all these items before submitting

Have you discussed your results with the relevant lecturer/examiner/school representative

If no, does your appeal application contain evidence/ documentation outlining attempt to do so

Does your application include the following:

Typed statement of the Appeal

Screenshot of Results from Online Examination Results Inquiry

Any other Documentation in support of your appeal (e.g Medical Certificate)

Payment Billing Details*

Cardholder Email*

Cardholder Phone*

Cardholder Address 1*

Cardholder Address 2

Cardholder Address 3

Cardholder City*

Cardholder Postcode/Eircode*

Cardholder Country*

Student Declaration*

By ticking this box I declare that all of the information in this appeal application is my own and approved by me.