Academic Appeal Form

To file an academic appeal, please complete the information requested below. You should make every effort to contact your instructor and attempt a resolution prior to submitting a formal appeal.

To begin the appeal form, please indicate the Academic Division in which the course is classified.

Academic Division(Required):

This field is required.

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This is the division in which the course is classified.

Your Information

Please enter your information below.

Only your information is required - do not add additional persons to this appeal request. Appeals must be requested on an individual basis.

Your Name (First, Last)

ID Number

DOB (YYYY-MM-DD)

Phone number

Email address

Address, City, State, Zip

Appeal Rationale

Please provide the following detail regarding your appeal:

Course Name and Section(Required) This field is required.

Instructor Name (First Name, Last Name)(Required) This field is required.

Term(Required)

Spring Summer Fall

This field is required.

Year(Required) This field is required.

Have you spoken to this instructor about this concern prior to filing an appeal?(Required)

Yes No

This field is required.

Please select the general nature of your appeal.(Required) This field is required.

Please provide details regarding your appeal.(Required) This field is required.

Supporting Documentation

Use this section to submit additional information/facts that support your appeal request. This may include copies of emails, graded assignments, etc. 5GB maximum total size.
Attachments require time to upload, so please be patient after submitting this form.

Your Information

Appeal Rationale

Supporting Documentation

Submission