ADMISSION DECISION APPEAL FORM
Student’s Full Name:
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Last First M.I.
Date of Birth: ___________________________ Phone Number: ____________________________________
This form is used by applicants who are not initially admitted to Austin Peay State University, upon application. The information provided on this form, your admissions application, your academic credentials, and all other application materials will be reviewed by the University
Admissions and Standards Committee. This committee does not look favorably on statements written by someone other than the student. Please print or type all information clearly. Please use additional sheets, if necessary.
The aforementioned information will be reviewed by the University Admissions and Standards
Committee. The outcome of an admission decision appeal is determined based on the applicant’s expected ability to academically succeed at APSU. Applicants admitted via the appeal process are conditionally admitted on probation and must meet University retention standards (published in the APSU Undergraduate Bulletin). The appellate source for further consideration after the University Admissions and Standards Committee is the Dean of
Enrollment Management.
This form must be submitted for consideration. Additional information that can be submitted, at the applicant’s option includes, but is not limited to the following:
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An additional personal statement from the student
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Any other additional information at the applicant’s discretion
All items should be submitted to:
Austin Peay State University
Office of Admissions
Ellington Building Lobby
Box 4548
Clarksville, TN 37044
OR
Fax: 931-221-6168

1. The most important concern in reviewing denied applicants’ appeals is to select students who will academically succeed at APSU. In your own words answer one of the following:
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Describe your activities in high school including extracurricular activities, employment, and any other information you feel is important in considering you for admission.
OR
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If you are 21 years of age or older, please describe your employment experiences since leaving high school and any other information you feel is important in considering you for admission.
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2. What are your personal interests and career goals?
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3. Are there extenuating circumstances which affected your grade point average or test scores?
If any, please explain the circumstance(s) and how your GPA and/or test scores were affected?
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4. In what ways have you prepared yourself to meet the challenges of attending Austin Peay
State University? Why do you want to attend college and in particular why would you like to attend APSU?
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I certify the above statements are correct and this form was completed by me, the applicant. I understand that giving false information on this form may make me ineligible for admission to
APSU.
Applicant’s Signature: __________________________________ Date: __________________