UNIVERSITY OF NORTH CAROLINA WILMINGTON
REQUEST FOR APPELLATE CONSIDERATION
Student Name: ___________________________________
Student ID:______________________________________
Appeal form must be returned to the Office of the Dean of Students, Fisher University Union, Suite
2013, within 2 business days of notification of original decision.
Explain in detail the reasons for appeal which you believe apply to your case. Ensure that your reasons
are substantial and can be verified. Attach any related documents you may have to support your
statement.
The designated appellate officer will limit review of the original hearing record to the following three
issues. Check all issues that will be addressed in the appeal.
( ) 1. An alleged violation of the rights guaranteed you;
( ) 2. The sanction imposed is too severe for the violation;
( ) 3. New evidence developed which has bearing on the verdict.
Be advised the decision to grant or deny an appellate review will depend upon the clarity of the
written request and upon the merit of its supporting documentation and/ or argument. Attach
additional pages to this form as necessary. (Please type or print.)
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All appellate review proceedings will be closed to the public.
Please sign and return this form to the Office of the Dean of Students.
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Student Signature
______________
Date
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Received by Office of the Dean of Students
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Date
Office of the Dean of Students, Fisher University Union, Suite 2013, (910) 962-3119
Revised 11/13/13