1. Mailing address:       City:
      2. State:         Zip Code:
      3. ***ACADEMIC CHALLENGE/APPEAL INSTRUCTIONS***
      4. Academic Challenge Review:


ACADEMIC CHALLENGE/APPEAL FORM
 

Student Name:            Student ID #:


E-mail address:                 Telephone:  



Mailing address:            City:



State:                 Zip Code:
 



***ACADEMIC CHALLENGE/APPEAL INSTRUCTIONS***

You must attach to this form a concise statement as to why you believe you are entitled to the action requested. You should give details about attempts thus far to resolve this issue. Attach copies of any relevant documentation that supports your request. Note: Academic challenges/appeals are not used for financial aid appeals or refund requests.
 
CHALLENGES: The challenge of a final grade or reinstatement into a class from which you have been withdrawn (dropped) should be discussed with the instructor first. If the dispute is not resolved, the instructor should complete this form and forward it to the division dean with a statement documenting the decision. For final grade challenges based solely on grade calculations and excessive absences drop challenges, if you do not agree with division dean’s decision, you may appeal to the Vice Chancellor for Academic Affairs for review, whose decision is final.

APPEALS: For final grade disputes not based solely on grade calculations, you may pursue an academic appeal (see “Academic Appeal” section below) and request a review by the Academic Appeals Committee. For academic suspensions, you may pursue an academic appeal. If you are not satisfied with the recommendation of the Academic Appeals Committee, you may appeal to the Vice Chancellor for Academic Affairs, whose decision is final.
 

 
 
ACADEMIC CHALLENGE  - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Indicate Type of Challenge:
  FINAL GRADE Request grade be changed
from
to
Course & Section:
   
Semester/Year:
 DROPPED FOR EXCESSIVE ABSENCES Course & Section:
Semester/Year:

 



Academic Challenge Review:

 

I have met with the student and have reviewed this request. I deny the challenge and have attached a statement explaining my decision. This matter should be forwarded to the Division Dean.
 
Instructor’s Signature: __________________________________________    Date: _________________
 

I have met with the student, and reviewed the student and instructor’s statements, grade book, syllabus, and any supporting documentation provided. In case of final grade recalculation, I have ensured a third-party recalculation has been conducted.
 
I grant the request and will take the following action: ______________________________________________________
I deny the request for the following reason: _______________________________________________________________
I deny the request because the student has initiated the challenge after the deadline.
 
Division Dean’s Signature: _________________________________________    Date: _________________

Copy: VCAA, Instructor; Original: Division Dean’s Office
 ACADEMIC APPEAL - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

 
Indicate Type of Appeal:

   FINAL GRADE (I have completed the challenge step above and my dispute is not solely based on a grade recalculation.)
 
  ACADEMIC SUSPENSION (I understand an academic appeal goes directly to the Academic Appeals Committee.)
I have not received satisfactory resolution, and I am now requesting a review by the Academic Appeals Committee.
 
Student’s Signature: _________________________________________    Date: _________________

Form 1440/002 (7/13)

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