STUDENT GRADE APPEALS FORM
Student Name ____________________________________________________________________
College and Major ________________________________________________________________
Date Appeal Grade Received: ____________________ Date Appeal Filed: ___________________
Course, Instructor, and Grade being Appealed
________________________________________________________________________________
________________________________________________________________________________
Meeting with Instructor to Appeal Grade Received (Date, Time, Place):
________________________________________________________________________________
Reasons for the Grade Appeal: (Please be as specific as possible.)
(Please attach additional sheets if more space is needed.)
Student signature _________________________________________________________
Dean signature ___________________________________________________________
STUDENT GRADE APPEALS FORM
PART TWO
STUDENT SCHEDULE: PLEASE ATTACH A COPY OF YOUR CURRENT SEMESTER
SCHEDULE
STUDENT MAILING ADDRESS (LOCAL):_______________________________
STUDENT PHONE:
_______________________________
STUDENT E-MAIL:
________________________________