Extenuating & Mitigating Circumstances Application Form

This form should be used under the following circumstances:

By candidates who are applying to sit their Part 2 examination more than four years of completing their Part 1 examination.
By candidates where an unforeseen personal situation arose prior to or during their examination which may have had a negative impact on their performance.

This form provides the FFLM with the information needed to support you before and during your examination and must be completed at the point of applying to sit the Part 2 examination or within 48 hours after sitting their examination.

Documentary evidence must be provided which can include a medical certificate or personal statement.

Information provided will be assessed by the FFLM’s Chief Examiner or a nominated deputy. Candidates will be informed via email of the outcome.

Further information can be found in Section 6 of the FFLM General Examination Regulations.

About you

Name(Required)

Title First Name Last Name

Email Address(Required)

Please enter the email address used upon applying for your examination.

Candidate Number (if known)

Exam Type(Required)

Examination Title(Required)

Please tell us about your application

Reason for Request(Required)

Other(Required)

Supporting Information(Required)

Please provide us with information about the nature of your request to assist the FFLM in considering your application.

Supporting Evidence

Please provide evidence to support your application.

Acceptable evidence includes:

A medical certificate
A GP letter

Supporting Documentation(Required)

Drop files here or

Max. file size: 8 MB.

Extenuating & Mitigating Circumstances Application Form

About you

Please tell us about your application

Supporting Evidence

Confirmation