Final Grade Grievance Appeal

Background Information

Please complete all information.

Your full name:

Your Student ID No. (Required):

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Course Name/CRN:

Involved Parties

Please include yourself, your instructor, and any individual(s) you would like to have included in the process.

Name

Select Role

Phone number (if known)

Email address (if known)

Questions

Please answer all questions to the best of your ability.

Please explain how you have attempted to resolve this matter with your instructor. An appeal cannot move forward unless a student has received a decision from their instructor in writing.(Required) This field is required.

Please provide a factual narrative basis and justification for the grade change request.(Required) This field is required.

What is your desired outcome/remedy?(Required) This field is required.

Supporting Documentation

You must attach your instructor's written grade grievance decision. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Background Information

Involved Parties

Questions

Supporting Documentation

Submission