Academic
Student Petition
Gordon State College Identification No: 929
-
For Office Use Only:
On-Line Petition No.
Date Entered:
Entered By
Date Documentation Entered on N: Drive:
Major:
Adviser:
Student's Name:
Date of Petition
Complete Mailing Address (Street, City, State, Zip):
Semester to which the petition applies:
Are you receiving Financial Aid?
Phone No. (
Yes
No
)
Do you expect to graduate this semester?
Did you take the final exam in the class(es) for which this appeal applies?
Yes
Yes
No
No
Check Check one box below, and submit your completed form to the office listed for that type of petition. That person will then transmit an
One electronic version to appropriate parties for recommending a decision.
To begin processing the following type(s) of petitions, submit the petition to the academic aide for the department/school of the student's
program of study or declared major.
If a major has not been declared, submit the petition to the academic aide for the department/school of the student's academic advisor.
Complete W ithdrawal from all classes after Mid-Term for Hardship or Extenuating Circumstances.
Degree Requirement Exceptions/Substitutions.
Physical Education W aiver
Reschedule a Final Exam
To begin processing the following type(s) of petitions submit the petition to the academic aide for the department/school in which the
grade was earned.
Drop/W ithdrawal of part of a schedule after Mid-Term for Hardship or Extenuating Circumstances.
Appeal of Previously Assigned Grades
The following petitions should be submitted to the student's advisor, then to the department head or dean of the school of the advisor and
then to the Registrar for completion.
Scheduling a Class Load of More Than Maximum Credit Hours Allowed.
FALL Maximum Hours Allowed - 18 semester hours
SPRING Maximum Hours Allowed - 18 semester hours
SUMMER Maximum Hours Allowed - 11 semester hours
Give a detailed explanation of what you are requesting and the reason for your request. Document any hardship and/or extenuating
circumstances as fully as possible, and explain specifically how these contributed to the need for this request. Specify the name(s) of your
instructor(s) and/or adviser. Attach additional pages to this form as needed. Petitions and appeals filed without proper explanation and
documentations will be denied.
Student's Signature
SP 0007 rev 07/24/2013
Date
Student Petition Guidelines
Documentation

Documentation is required to accompany any petition when it is received--petitions are not accepted without all & proper documentation at
time of submission. (See List for types of Acceptable Documentation).
Before Submitting a Student Petition:

Discuss your course progress with your instructor(s) for guidance.

Withdraw from course(s) by the published deadline in your academic catalog to withdraw without penalty.

Consider requesting an Incomplete (Grade of I) from your instructor(s).
o See Gordon State College Academic Catalog 2013-2014 section Grading System and Grade Point Average, for information on this
request.

Check to see if these areas of your academic life will be impacted:
o Learning Support Students may not withdraw from all Learning Support Courses unless they withdraw from all credit level courses.
o Financial Aid

Withdrawing from courses may require repayment of funds already received.
o Health Insurance
o Residence Life

If you live in the dorms refer to the 2013-14 GSC Academic Catalog section, Residence Life, for residency requirements to
determine if your withdrawal will affect your housing privileges
o Veteran’s Benefits
o Immigration Status

If you are an international student attending Gordon State College on an F-1 student visa, contact the Registrar’s Office to
see how your withdrawal will affect your status with the U.S. Department of Homeland Security.
Submitting a Petition for a hardship withdrawals
Purpose:
The purpose of a hardship withdrawal is to allow students who have experienced an unanticipated, incapacitating hardship or extenuating
circumstance, which prevented them from completing courses or officially withdrawing by the stated deadline, the right to withdraw without
penalty.

Acceptable Reason(s) for Hardship Withdrawal:
o Medical
o Psychological
o Deaths, Accidents
o Legal Issues
o Military Requirements
Procedure:
1. Complete paper student petition form
a. You can find copies of the form
i. In each Academic Department
ii. In the Registrar’s office
iii. By printing a copy from the Registrar’s web page
2. Complete detailed but brief, printed or typewritten explanation outlining the events in chronological order, of what happened, when and how it
prevented your success in your classes.
a. Clearly outline details of petition and how hardship or extenuating circumstances affected your ability to complete coursework.
Submit a typed or handwritten brief explanation, with a chronological listing of events, which can be documented, showing the dates
the events occurred which prevented course completion.
i. Explanations Should Include Answers to All Questions below appropriate to your situation:
1. What did you experience that prevented you from being successful this semester?
2. When did these events begin and how did they impact your attendance and academic success?
3. Are conditions/circumstances ongoing? If so, when will they end?
4. What type of assistance or medical attention did you receive to help you through the hardship or extenuating
circumstances?
5. When did the assistance or medical attention begin?
6. Are you still receiving this help?
7. What prevented you from officially withdrawing by the deadline?
a. See Dropping Courses, of the 2013-2014 GSC academic catalog for information concerning deadlines
for filing student petitions.
8. Can you provide official documentation to support the points stated in this appeal within time constraints?
9. Will you be capable of performing at full capacity when returning to school?
10. If withdrawing from Part of a Schedule, explain why some of your courses were affected by your hardship and
others were not.
11. Once you have completed all of the steps outlined for the student petition, submit your petition to:
a. Complete Withdrawal from all Classes after Mid-Term for Hardship or Extenuating Circumstances
b.
e.
To the academic aide for the department/school of the student’s program of study or declared
major.
c. If a major has not been declared, submit the petition to the academic aide for the
department/school of the student’s academic advisor.
d. If the student has not been assigned an academic advisor, submit the petition to the department of
one or more involved classes.
Drop/withdrawal of Part of a Schedule after Mid-Term for Hardship or Extenuating Circumstances:
f. Submit to the academic aide for the department/school in which the grade was earned.
Submitting a Petition for a Degree Requirement Exception/Substitution or Physical Education Waiver
Purpose:
The purpose of a petition for a Degree Requirement Exception/Substitution is to allow students the possibility of using one course to fulfill the
requirements for another course for a degree program.
Procedure:
To apply for a Degree Requirement Exception /Substitution
1. Complete paper student petition form (see locations of the form listed under hardship withdrawals)
2. Complete detailed but brief, printed or typewritten explanation describing both courses that are to be considered for the petition.
a. Explain in detail how the requested course fits the description of the requested area of substitution.
b. Attach official course descriptions for all courses listed in student petition.
3. Submit petition to appropriate academic aide for the department/school of your program of study.
Submitting an Appeal of Previously Assigned Grades
Purpose:
 Student feels test, quiz or final grade was miscalculated
 Student was not provided with proper accommodations as assigned by Student Counseling Director.
 Student was not granted full amount of time to complete assignment or test.
Procedure:
 Student must appeal within established deadlines as stated in your academic catalog
 Before filing an Appeal for Previously Assigned Grade petition, the student must first discuss situation with the professor in an effort to resolve
grade disagreement.
 If no resolution is reached, student will then request a meeting with professor's department head.
 If resolution is not determined at this level, student can file a petition.
o Complete paper student petition form (see locations of the form listed under hardship withdrawals)
o Complete detailed but brief, printed or typewritten explanation stating the reasons that the grade assigned should be reviewed and
possibly amended.
o Submit petition to appropriate academic aide for the department/school of your course being petitioned.
Submitting an Petition to Reschedule a Final Exam
Purpose:
 Student has three or more final exams scheduled for one day. The student may petition to take the third and/or fourth exam on a different day.
Procedure:
 Student must appeal within a reasonable amount of time to allow resolution before the originally scheduled date for the final exam.
 Before filing a petition, the student must first discuss situation with the professor in an effort to resolve and tentatively reschedule the exam.
 If resolution is not determined at this level, student can file a petition.
o Complete paper student petition form (see locations of the form listed under hardship withdrawals)
o Complete detailed but brief, printed or typewritten explanation stating the reasons that the scheduled exam date should be reviewed
and possibly amended.
o Submit petition to appropriate academic aide for the department/school of your course being petitioned.
Scheduling a Class Load Higher than the Maximum Credit Hours Allowed
Purpose:
 Student wishes to take more than 18 hours during fall or spring semesters or more than 11 hours during summer semesters.
Procedure:

Complete paper student petition form (see locations of the form listed under hardship withdrawals)

Complete detailed but brief, printed or typewritten explanation stating the reasons that your maximum allowed credit hours should be
reviewed and possibly amended.

Submit petition to appropriate academic aide for the department/school of your academic advisor
Documentation Required for Student Petitions
Petitions received without proper documentation will be denied.
All documents submitted must be on official letterhead of documenting provider including names, addresses, office locations, phone
numbers, and signatures of provider and legible printed name of provider. All documentation will be verified for authenticity--any
documents received without pertinent information needed for verification will not be considered as support for the appeal.
Submission of altered documents, or false information will warrant disciplinary action and possible legal charges.
Types of Documentation Accepted:
Medical/Psychological
documentation must include:
• Brief statement from attending physician of medical condition and diagnosis & how condition would
prevent student from successful course completion.
• Must show actual dates of office visits.
• Original medical statements/bills showing dates patient received treatment will be accepted if
information covers appeal period. For verification purposes, this documentation must indicate all
pertinent information listed in the above paragraph—All documents submitted……
• Hospital/Medical Facility – admission and discharge paperwork with all pertinent information to verify
student’s explanation.
Deaths:
• Death certificates, obituaries from newspapers and on-line printouts of death announcements should
contain name of student as a relative of the deceased.
• Any notice/obituary/on-line printout must indicate facility that officiated services or preformed
cremation showing name address and phone numbers of facility whether in state or out of state.
• All forms of documentation must indicate name of deceased, date of death and date documentation was
published.
Accidents
• Police Reports / Motor Vehicle Reports:
• All pages of police reports are required. Partial reports are not acceptable. Reports are normally 2-4
pages.
From Landlord
• Documentation concerning residencies must bear the same name as on the petition.
Employment
• Dates first employed
• Date of dismissal
• Official check stub
• Official schedule of hours worked or working
• Official schedule of change of hours in work schedule
• Supervisor's or manager's name
• Company name, Address, Phone number where individual that signed documentation can be contacted.
All names of signees must be legible; typed or printed above/below the signature.
Military
• Official orders to report for active duty/deployment or reserve training
Gasoline tickets:
• If student's explanation including driving to a far destination that required gasoline purchases:
• Gas receipts showing date and location of purchase will be considered as documentation. (In-state or
Out-of-State)
Vehicle Repairs
• Student GSC parking ID Number
• Vehicle repaired must match vehicle information on student’s GSC parking permit
• Must show name, address and phone number of repair shop.
Airline Tickets or
• Must indicate student's name
Boarding Pass
• Show Date of Departing Flight & Destination and date must support student's explanation.
• Show Date of Returning Flight & destination and date must support student's explanation.
E-mails
• Correspondence between student, professors, staff relating to appeal.
Coursework
• Copies of tests, quizzes, or course work.
Course Descriptions &
• Complete course descriptions and syllabi of current courses & current college
Syllabus
• For courses completed at other schools, the course descriptions and syllabi of courses from that
institution.
Student Academic
• Copies of student’s academic summary indicating current Grade Point Average (for class overloads)
Summary