Reasonable Adjustment Application Form

This form should be completed by candidates wishing to apply for a reasonable adjustment during the assessment of our qualifications. In cases where the candidate is unable to submit the application themselves, the Approved Training Centre/Provider (ATC/P) Co-ordinator or Trainer Assessor (TA) may submit the application on their behalf.

All reasonable adjustments will be applied in line with RLSS UK Qualifications policies. A copy of the application outcomes may be sent to the ATC/P Co-ordinator or TA for their records, who will be required to retain this with course/assessment records for audit and regulatory purposes.

Please provide as much information as possible to enable the compliance team to make a valid and reasonable judgment of individual circumstances and to avoid any delays.

Part 1 Candidate Details

Candidate Name

Candidate Email (required)

Candidate Date of Birth (required)

Candidate Society Number

Candidate Telephone Number

Part 1A Applicant details (if different to candidate details)

Applicant Name

Applicant Email Address

Applicant Telephone Number

Part 2 Qualification

Qualification

Part 3 Details of the reasonable adjustment

Reason for the reasonable adjustment request (provide as much detail as possible). For example: 50% extra time and the use of a translating dictionary for theory assessment if English is not your first language. (required)

Summary of evidence to support your application (e.g., Statement from education setting) (required)

Part 4 Confirmation

By submitting this form I confirm that

1. The contents of this form reflect accurate details of the special conditions to be made
2. I have included all relevant evidence and times frames to be considered
3. I agree to the RLSS UK privacy policy (www.rlss.org.uk/privacy-policy)

RLSS UK is committed to protecting your personal data in accordance with the Data Protection Act 2018 (DPA18) and the UK General Data Protection Regulations (UK GDPR).
By completing this form, you consent to RLSS UK processing your personal data in order to process your application form.
RLSS UK is fairly and lawfully collecting this data under the UK GDPR Article 6 1(a), where the data subject has given consent to the processing of his or her personal data.
RLSS UK only captures the necessary personal data to conduct this purpose and will only use the captured data for the agreed purpose.
As RLSS UK hold your data for this agreed purpose based on your consent, you have the right to withdraw your consent at any time. Please email [email protected] if you wish to withdraw your consent.
RLSS UK retain this data for 6 years after which it will be permanently deleted from our RLSS UK systems.
Please refer to RLSS UK’s www.rlss.org.uk/privacy-policy for further information on how we handle your data.

Send