Behavioral History Review Committee Appeal

Name

Your E-Mail Address

Phone Number

Address

City

State

Zip Code

Basis For Appeal Provide new information that was not available to the BHRC and was not included or available in the initial review of the applicant's file. Please attach additional information below as needed.

Please attach addtional informtion as needed

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A Department of STUDENT AFFAIRS

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University of Louisville

Louisville, Kentucky 40292

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Phone

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fax (502) 852-1429

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