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

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

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

Please insert the programme code in this field e.g. 1BA1, 5MB3
Please insert the module name in this field e.g. Principles of Physiology
Please insert the module code in this field e.g. AN123
Please insert the module name in this field e.g. Principles of Physiology
Please insert the module code in this field e.g. AN123
Please insert the module name in this field e.g. Principles of Physiology
Please insert the module code in this field e.g. AN123
Please insert the module name in this field e.g. Principles of Physiology
Please insert the module code in this field e.g. AN123
Please insert the module name in this field e.g. Principles of Physiology
Please insert the module code in this field e.g. AN123
Please insert the module name in this field e.g. Principles of Physiology
Please insert the module code in this field e.g. AN123

Grounds for Appeal*

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

  1. Involvement in an accident or serious incident
  2. An acute illness, injury, or trauma
  3. Deterioration in an ongoing medical or health condition, or adverse change in a fluctuating condition
  4. Life-threatening illness or death of a person with whom you have a close relationship
  5. Significant adverse personal or family circumstances
  6. 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)
  7. A victim of crime or threatening behaviour
  8. Other significant and relevant exceptional factors for which there is evidence that academic performance has been impaired.
(Max of 300 words)

Statement of Appeal

(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*

Check List*

You must confirm you have checked all these items before submitting


Does your application include the following:

Payment Billing Details*

Student Declaration*