Grade AppealRequest Form

Type of Grade Appeal

Student's Full Name:

Phone Number:

Email Address:

Email address must be of a valid format.

Type of Grade(Required):

This field is required.

Semester Grade Earned(Required):

This field is required.

Year:

Student Contact Information

Your Full Name

Daytime Telephone Number

Course Information

RCCC Student ID Number(Required) This field is required.

Student College Email Address(Required) This field is required.

Course Instructor Name(Required) This field is required.

Course Prefix(Required) This field is required.

Course Number(Required) This field is required.

Course Section(Required) This field is required.

Have you emailed your instructor? Please note, this is the mandatory first step in the appeal process. If you have completed this step, please attach your email(s) to this report.(Required)

Yes No Yes, but I have not received a response from my instructor. Yes, but I disagree with my instructor's response.

You must make at least one selection.

Please provide a summary of your appeal request, including the basis for your appeal. Identify the specific course grade or assignment grade in question.(Required) This field is required.

Supporting Documentation

Photos, video, email, and other supporting documents may be attached below. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Email me a copy of this report

Grade Appeal
Request Form

Type of Grade Appeal

Student Contact Information

Course Information

Supporting Documentation

Submission