Request for Consideration of Extenuating Circumstances in the Co-op Admission Process

If you are eligible for an admission interview and wish us to consider one of the four extenuating circumstances identified below when making admission decisions, please follow these steps:

•  print and complete this form.  
• write a letter explaining the impact your extenuating circumstances had on your grades, and/or your ability to work or participate in volunteer service and extracurricular activities, or the impact your circumstances will have on your interview performance.
• obtain supporting documents
• bring this form, your letter of explanation, supporting documents, and two copies of your resume to the Co-op Office at 192 King Street North at least 48 hours (two business days) before your interview.

(Note:  The form on this page is only for students who achieved at least the minimum GPA required to be eligible for an admission interview, and who would like us to consider their extenuating circumstances when making admission decisions. There is a separate form for students seeking an exemption from the minimum GPA required to obtain an admission interview.)

		Assessment Area Place a check mark beside the assessment areas on which your extenuating circumstances had an impact, or would have an impact during the interview.
	1.	Work experience.
	2.	Volunteer service and extracurricular activities.
	3.	Academic record in first year.
	4.	Performance during the interview.
		Extenuating Circumstances Place a check mark beside the applicable circumstances.
	1.	A learning disability that your educational institution was unable to accommodate, or that will have an impact on your performance in an interview.
		Provide documentation from Accessible Learning or similar service providers.
	2.	An ongoing chronic, debilitating, and serious health problem.
		Provide medical documentation that you received ongoing medical treatment in senior high school and/or first year, missed considerable time from classes, and that your ability to submit assignments and write exams was impacted (through verification by school officials at high school and/or faculty and approval of petitions).
	3.	A death in your immediate family (parents/guardian and siblings) during senior high school or your first year at Laurier.
		Provide documentation.
	4.	A serious and prolonged illness that occurred during senior high school and/or your first year at university.
		Provide documentation that you received ongoing medical treatment, missed considerable time from classes, and that the illness had an impact on your ability to submit assignments and write exams. (If the illness occurred in first year, include verification by faculty and approval of petitions.) Common illnesses such as mononucleosis, strep throat, and influenza will not be considered unless documentation is provided as specified in #2 and illness of at least one month is confirmed.

Name:
Laurier e-mail:

Check boxes:

	I have attached a letter explaining my extenuating circumstances in detail.
	I have attached documentation verifying my claims.

We are able to consider your request only if you submit this form and your letter before your admission interview.