Student Appeal Request Form


Please specify and explain why you are submitting this appeal. You may select multiple grounds for an appeal.

Reason A:

Reason B:

Reason C:

Reason D:


By signing this form, I hereby assert that the statement (and related documents) attached is true and may be shared with the Vice Provost for Student Affairs Office, Dean of Students Office, and complainant or accused student (if applicable). In the event that any individual knowingly offers false information, that individual may be subject to conduct action taken by the University, including but not limited to suspension from the University.