Application to restart the Scheme for Registration

You should complete this form if you are applying to restart the Scheme for Registration one further time only.

As per the Scheme for Registration Regulations, you may apply to restart the Scheme for registration one further time only in the following circumstances:

a) where you are a Disabled Person and – as a result of your disability – you are, or will become, unable to pass the Scheme for Registration in the Allotted Time

and/or

b) where, due to Exceptional Circumstances you are, or will become, unable to pass the Scheme for Registration in the Allotted Time.

In order to apply to restart the Scheme for Registration one further time, please fill out the form below, stating your reasons for restarting along with any supporting evidence.

Find out dates of future Examination and Appeal Panels and their corresponding deadline dates.

Full name *

Member number *

Email *

Postal address *

Reason for restarting (select all that are appropriate) *

I am a Disabled Person

Due to Exceptional Circumstances

Description of disability and/or exceptional circumstances

Please describe the disability and/or exceptional circumstances that you wish the Examinations or Appeals Panel to take into account. Please be specific about how your disability / the circumstances have affected / will affect your progress through the Scheme, including exact dates. *

Please attach evidence, in English, of your disability / exceptional circumstances (e.g. letter from healthcare professional, supporting statement from supervisor etc) and list this below. This must be in pdf format.

If you need to submit additional evidence, please email this, in pdf format only, to education.ea@college-optometrits.org.

Document 1 [PDF file only]

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Document 2 [PDF file only]

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Document 3 [PDF file only]

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Or, I do not wish to submit any evidence

Declaration

The information provided in this form, and any additional supporting information that you provide, will be held by the Education Department at the The College of Optometrists in accordance with the Data Protection Act 2018. All personal details will be redacted before being presented to the Examinations and / or Appeals Panel.

In considering an application, the panels may request additional information from: a) The Trainee; b) The Trainee's Supervisor; c) The Assessors; d) The Trainee's medical practitioner(s) (providing the Trainee has given consent); e) Any other person whom the Examinations Panel at its absolute discretion considers appropriate.

This additional information will be shared with the Trainee and the Trainee will be given the opportunity to submit comments in writing on the information before the meeting.

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Application to restart the Scheme for Registration

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Description of disability and/or exceptional circumstances

Declaration

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