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Student Declaration Academic Concession MATH

This document is a Student Declaration form for requesting academic concessions in math courses at UBC. It allows students to declare circumstances affecting their academic performance, such as medical issues or conflicting responsibilities, without traditional documentation. The form must be submitted to the course instructor and does not guarantee the concession will be granted.

Uploaded by

Henry Chang
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14 views1 page

Student Declaration Academic Concession MATH

This document is a Student Declaration form for requesting academic concessions in math courses at UBC. It allows students to declare circumstances affecting their academic performance, such as medical issues or conflicting responsibilities, without traditional documentation. The form must be submitted to the course instructor and does not guarantee the concession will be granted.

Uploaded by

Henry Chang
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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STUDENT DECLARATION OF ACADEMIC CONCESSION FOR MATH COURSES

Fill this form out and scan or hand it to the instructor of the course.

This form is for in-term academic concessions only. Students requesting an academic concession for
final assignments or exams must consult their Faculty Advising Office.

This Declaration is intended to support students navigating circumstances that constitute grounds for
academic concession, including conflicting responsibilities, medical circumstances, and/or compassionate
grounds, that does not fall within the ability to provide traditional documentation otherwise required per
the UBC Academic Concession policy, V-135. The Department of Mathematics recognizes that
experiencing a challenging emergency or unanticipated event is impactful on a student’s ability to fulfill
close in time academic commitments. In such circumstances, we want to ensure that you are well
connected to support resources and to help you navigate your academic options.

DECLARATION – TO BE COMPLETED BY STUDENT

COURSE: MATH ____________


200 SECTION: ___________
101 Academic Term: _____________
1

I declare, confirm and acknowledge that:


1. A recent challenging emergency/unanticipated situation arose that has impacted or is impacting my
academic performance;
2. The nature of my situation falls under one or more of the following categories:

☐Conflicting Responsibilities
☐Medical Circumstances
☐Compassionate Grounds

3. The details and report of my situation:


Headache. Cold.

4. This report is true and accurate;


5. The submission of false information on this Declaration may be investigated as academic misconduct;
6. The Department of Mathematics reserves the right to request supporting documentation; and
7. The submission of this Declaration does not ensure the granting of the academic concession request.

Student Signature: ______________________________________


Henry Chang Date: __________________________
11/7/2024

Chang
Family Name: ___________________________________ Preferred Name: ________________________
Henry

22312862
Student Number: ______________________________

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