APPENDIX G

FINAL GRADE APPEAL FORM

 

Please complete the information below and attach a copy of your written rationale/basis for the grade appeal.

 

Student’s Name:___________________________________________________________

 

Mailing Address:___________________________________________________________

                         

                             ___________________________________________________________

 

Home Phone #:__________________________ Cell Phone #: ______________________

 

Course # & Title:__________________________________________________________

 

Instructor:___________________________ Term: _______________________________

 

____________________________________Date:_______________________________

(Student Signature)