Appeal Form- The Graduate School

Background Information

A graduate student may file an appeal with The Graduate School when they are in disagreement with actions taken or academic consequences imposed by an individual faculty member, graduate program, department, school, or college and when all good faith efforts to resolve their concern either through direct communication with the individual(s) involved or through applicable procedures in the graduate program, department, school, or college have failed.

Categories of actions or academic consequences that an appeal might address includes, but is not limited to, those listed here:
a. Academic Dismissal
b. Termination of Status
c. Allegation of Scholarly Misconduct
d. Academic Consequences imposed by allegation of Scholarly Misconduct

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Your full name:

Your position/title:

Your phone number:

Your email address:

Email address must be of a valid format.

Your physical address:

Appeal Type(Required):

This field is required.

Date of incident(Required):

This field is required.

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If there is no specific date of incident, please include date of contact with The Graduate School

Location of incident(Required):

This field is required.

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Field of study of person filing appeal

What type of program?:

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(i.e.,Certificate name, M.A., M.S., Ph.D., etc)

Involved Parties

Please list the individuals involved (including yourself), including as many of the listed fields as you can provide. Please do not create an ID number if you do not know it.

Name or Organization

Select Role

ID Number

Phone number

Email address

Hall/Address

Questions

Please provide a detailed description of the actions or academic consequences giving rise to the Appeal.(Required) This field is required.

Please provide a description of actions already attempted to resolve the concern (e.g., correspondence with the person(s); records of meeting with graduate program directors, department heads, or deans)(Required) This field is required.

For appeal of Academic Dismissal or Termination of Status: Please provide a description of a plan for removing barriers to successful program completion. This field is required.

List and describe any attached documents including emails, records, materials, and other information pertaining to your complaint.(Required) This field is required.

Supporting Documentation

Please include any documentary evidence (e.g., correspondence, notes, descriptions of interactions, and dates occurrences) supporting the allegations. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

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Background Information

Involved Parties

Questions

Supporting Documentation

Submission