Forms & Documents

Procedure to submit an Grade appeal.

1. Contact your instructor, through email, meeting, or telephone. If contact with instructor is unable to occur (example: instructor is sick or unable to respond to student) Then the student

   can progress to the next step.

2. Write a formal letter to the committee detailing the reason for the appeal. Students need to provide graded work, attendance records, quizzes, and any other information they’ve through the course to support their case.The letter and supporting evidence along with the form below should be submitted to the Appeals Committee.

Note:

• An Appeal must be made to the Appeal Committee within the first 3 days of the new semester
• Only D and F grades will be considered and the course must be taken during last semesterOnly 2 petitions per student per semester (you can petition for multiple courses on each petition when the circumstances are the same.)
• Students that are in the grade appeals process must attend classes as scheduled while the process is taking place. For example, if a student failed Math class, they are to attend that

  class and other classes whatever are on their schedule until further notice.

After the appeal has been submitted it is reviewed. If the request for review is not dismissed, the Appeal Committee will:

1. Submit a copy of the student’s written statement to the teacher with a request for a written reply within 3 working days. (If this step has not been taken prior.)
   Note: If it appears that the dispute may be resolved between the student and the teacher, the committee will attempt to arrange a mutually agreeable solution between these two parties.
2. If a mutually agreeable solution is not achieved, the Committee will proceed to hold a meeting concerning the allegations.
All grade appeal decisions are final.

This process takes approximately 1 week. You will be notified in writing of the result of your appeal

  The Form

Student Appeal Form

• Name and Contact information Please provide your name, email and other contact information in case the committee has follow up questions.
• Student Name *
• Email *
• Address
  Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountry
• Phone
• The Incident Please provide the Course and Instructor along with the date/time of the incident
• Course If not regarding a specific course this can be skipped
• Instructor If not regarding a specific instructor this can be skipped
• Date/Time and Semester Please provide the date/time and the semester the incident occurred.
• What is the grievance related to?
  Please check one or more of the followingGrade (Single grade for a test or assignmentFailure of CourseDisciplinary ActionTermination from the ProgramOther
• Please Describe the grievance *
  Please describe grievance provide any details and use the option below to attach any support documents.
• Attachmentss Please provide any support evidence to go along with your grievance.
• Please select: *
  I do wish for my student records and grades to be reviewed by the Appeal Committee in support of my appeal.I do NOT wish for my student records and grades to be reviewed by the Appeal Committee in support of my appeal.
• Note: Please review your selections before submitting. By submitting this document you are attesting the information included is correct to the best of your knowledge,

 

Verification

• Please enter any two digits *Example: 12
• This box is for spam protection - please leave it blank:

In order to initiate and pursue a grievance, the following steps must be observed, in their entirety, within two (2) business days following the reported incident or reason for the grievance.

• The student must first meet with the instructor(s) or person(s) directly involved, in an attempt to resolve the grievance through informal discussion. This person must sign the Grievance Form to confirm that the student has met with him/her.
• If there is no resolution, the student may next schedule an appointment and orally explain the matter with the Nursing Programs Administrator. The student should be prepared to discuss: the basis for

  concern, facts to support the grievance, and suggested remedy that would satisfy the student. This person must sign the Grievance Form to confirm that the student has met with him/her.

• If there is no resolution, the student may submit two copies of a written grievance letter. The student should deliver one copy to the Nursing Programs Administrator and one copy to the Appeal Committee

  Chairperson, along with the Grievance Form. The letter should be typed, dated, and signed, and should minimally contain the following information: the course and instructor(s) or person(s) involved; a summary of

  the events that led to the grievance; facts that support the student’s grievance; and the suggested remedy that would satisfy the student.
  During the appeals process, student can continue with class and clinical unless the reason for the appeal is due to a violation of code of conduct and/or unsafe practice at the clinical site.
    The Form

  Student Appeal Form

  • Name and Contact information Please provide your name, email and other contact information in case the committee has follow up questions.
  • Student Name *
  • Email *
  • Address
    Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountry
  • Phone
  • The Incident Please provide the Course and Instructor along with the date/time of the incident
  • Course If not regarding a specific course this can be skipped
  • Instructor If not regarding a specific instructor this can be skipped
  • Date/Time and Semester Please provide the date/time and the semester the incident occurred.
  • What is the grievance related to?
    Please check one or more of the followingGrade (Single grade for a test or assignmentFailure of CourseDisciplinary ActionTermination from the ProgramOther
  • Please Describe the grievance *
    Please describe grievance provide any details and use the option below to attach any support documents.
  • Attachmentss Please provide any support evidence to go along with your grievance.
  • Please select: *
    I do wish for my student records and grades to be reviewed by the Appeal Committee in support of my appeal.I do NOT wish for my student records and grades to be reviewed by the Appeal Committee in support of my appeal.
  • Note: Please review your selections before submitting. By submitting this document you are attesting the information included is correct to the best of your knowledge,

   

  Verification

  • Please enter any two digits *Example: 12
  • This box is for spam protection - please leave it blank: