Appeals Form

This form should be used to submit appeals to Gateway Qualifications.

Please ensure you have read the Appeals Policy and Procedure before completing the form.

Learners who wish to make an appeal should either be supported by their Centre or should have exhausted their Centre’s own appeals process before appealing to Gateway Qualifications.

Access to HE learners who wish to appeal should refer to the Access to HE Diploma Learner Appeals Policy.

Centre No.*
Centre Name*
Qualification title or focus of the appeal*

The cohort(s) and/or learner(s) affected by the appeal

Enter Cohort IDs or Learner Numbers. Please do not include learner names. Click + sign to add more rows.

Nature and detail of the appeal*
Attach further evidence here (if applicable)
Max. file size: 50 MB.
Supporting evidence is attached?*
- Yes
- No
If so, please specify
DECLARATION: I am satisfied that the information provided is accurate and fully supports the application*
First Name Last Name
Date*
MM slash DD slash YYYY
Centre quality contact details*
The quality contact will be emailed a copy of the information submitted in this form.
Quality First Name Quality Last Name
Centre quality email*
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