Free Academic Appeal Form Template
Academic Appeal Form
Please complete this form to request a review or reconsideration of an academic decision made by your institution.
Name
Student ID
Program/Course
Phone number
Appeal Information
Date of Decision
Type of Appeal
-
Grade Dispute
-
Academic Probation
-
Suspension or Expulsion
-
Dismissal from Program
-
Missed Deadline/Extension Request
Description of the Decision Being Appealed
Please provide a brief explanation of the decision you are appealing.
Reason for Appeal
Please explain why you believe the decision was incorrect or unjust. Provide any supporting evidence if applicable.
Resolution Requested
What outcome would you like to see as a result of this appeal?
Signature
Name:
Date:
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