GRADE APPEAL FORM
Directions: Please complete this appeal form, attach any supporting documentation you may have, and return it to the
appropriate Associate Dean’s Office (see next page). The Associate Dean will respond in writing to your request within 15
school days.
Please visit http://www.grcc.edu/grievance for additional details regarding the Student Academic Grievance Procedure.
Name:
Student ID Number:
Address:
Phone Number:
Date of Birth:
Email:
Course Name, Number and Section (e.g. EN 101-2323):
Semester & Year (e.g. Fall ’06)
Instructor:
Grade Received:
Grade Expected:
Please give a detailed explanation of why you are appealing your final grade. Feel free to attach additional pages, if
necessary. Attach a copy of any supporting documentation you may have.
I hereby authorize Grand Rapids Community College to review my academic records and all information pertinent to this
grade appeal. I certify that all statements I have made regarding this grade appeal are truthful.
Signature:
Date:
Do Not Write Below This Line – Associate Dean’s Office Use Only
Date Appeal Received:
Signature:
Grade Appeal Form • Page 1 of 2
Grand Rapids Community College Associate Deans
Bill Faber
English, Language & Thought, Performing Arts,
Psychology, Education/Child Development, Social
Sciences, Visual Arts, Biological Sciences, Math,
Physical Sciences, Wellness
Phone: 616-234-2358
Fax: 616-234-3838
Email: wfaber@grcc.edu
Paula Sullivan
Criminal Justice, Health, Hospitality, Applied
Technology, Business, Computer Applications, Drafting
& Design, Manufacturing
Phone: 616-234-4340
Fax: 616-234-4234
Email: psullivan@grcc.edu
Dr. John Cowles
College Learning Studies
Phone: 616-234-3449
Fax: 616-234-3546
Email: jcowles@grcc.edu
Grade Appeal Form • Page 2 of 2