Application for Aegrotat Consideration

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Email

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Qualification	Course Code and Name	Exam Date	Exam Time

Provide details upon which this application is based.

Please download this form

Download Aegrotat-Consideration-Medical-Statement.pdf

Name of Deceased:

Relationship to Applicant:

Date of Death:

Place of Death:

Date of Funeral:

Place of Funeral:

Please upload the death notice from a newspaper to support all applications involving bereavement. The relationship between the applicant and the deceased must be apparent or verified.

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Please explain nature of relationship if other than a close relative or if the relationship to the deceased is not apparent or verified:

Please provide any supporting evidence that may assist your application. Acceptable evidence can be:

medical certificates covering the time of your exam/s
death certificates, newspaper death/funeral notices and/or a statement from a funeral director/officiating celebrant/kaumatua
police or legal documents
email attestations made by others – please provide these people’s contact details and let them know we may contact them to verify the information they have provided.

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Application for aegrotat consideration

Examination Details

Bereavement/Tangihanga