See Regulations

Application for assessment of circumstances

The MOMI act requires all non-EU/EEA student with a residence permit for study purposes at the UT to achieve sufficient academic progress (50%). If you are unable to meet the MoMi requirement for the current academic year due to one of the justifiable grounds for study delay, you can submit this application for assessment of your circumstances to the Committee Personal Circumstances (CPO) before the 1st of August of the current academic year.

Your case will be dealt with confidentially. No data is shared unless you gave permission. There will be no mention on your diploma of any matters that you discuss with a study advisor, a student counselor or a student psychologist

Personal data


Educational data

Information about your most recent study of current academic year

Study delay due to:

A medical certificate of a Dutch doctor or a Dutch BIG-registered psychologist is required. Questions? Please contact

A medical certificate of a Dutch doctor or a Dutch BIG-registered psychologist is required. Questions? Please contact

A medical certificate of a Dutch doctor or a Dutch BIG-registered psychologist is required. Questions? Please contact

A birth- and/or medical certificate is required

Lodge with supporting documents/statements. If not possible, please contact

Lodge with decision on activism grants.

Lodge with supporting documents/statements.

In case of Top-Level Sports or Top-Level Arts, a decision from Committee Topsports or Topculture is required

Lodge with supporting certificates/statements

In which period of time of the current academic year the circumstance took place? (Dates need to be within the current academic year)

Upload the above-mentioned required documents

Explanation of your personal circumstances

Please explain your personal circumstances below to clarify the application

What is the personal circumstance and what does it mean?

To what extent and in what way did the personal circumstances influence your studies?

What actions did you take to cope with the circumstances?

Did you have contact with healthcare providers from within or outside the UT because of the personal circumstances, or have you sought help in another way?

Contact with fainco or study adviser

Study delay should have been reported to your Fainco or study adviser.

If you have not contacted your study advisor about the study delay yet, please do as soon as possible.

Contact with student counsellor

An appointment with a student counsellor is mandatory.

If you have not yet made an appointment with a student counsellor, you can make an appointment by calling the secretariat of Student Affairs Coaching & Counselling, phone +31 53 489 2035.

Permission to share data

Please read all of the information below.

Cooperation CPO and SACC: The student counsellors are part of the department "Student Affairs, Coaching & Counseling" (SACC). The CPO and the student counsellors work closely together. The CPO discusses data from this application with the student counsellors in order to provide you good and complete support regarding MOMI and other regulation. By submitting this application, you are informed about this cooperation and automatically give permission to the CPO to discuss the contents of this application with the student counsellors.

The CPO does not share information with others without your permission

The CPO will seek advice from your fainco/study advisor during the processing of this application, because you are obliged to report the circumstances to your study advisor/Fainco as soon as reasonably possible. Subsequently, an adjusted study plan needs to be drawn up. The CPO advises the MOMI Committee UT about your personal circumstances, the MOMI Committee UT gives you the final notification regarding MOMI. It is advisable for your MOMI file and for possible help from your programme that the CPO and your study advisor/Fainco can share information.