Third-time Course Appeal Form

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Students please complete the form below if you are appealing to repeat a course. Students should only complete this form if this is your third time repeating a course. Once the form is submitted to the committee you will be contacted on their decision.

Please complete the form below:

Date:

YYYY

Time:

Time

Name:

Student ID number:

Email:

Phone Number:

Major:

Classification:

Freshman

Sophomore

Junior

Senior

Clear selection

Please identify the course that you are appealing:

How many times have you taken the course?

Once

Twice

This will be the third time.

Clear selection

Please identify the name of the professor that you had for the course the first time that you enrolled:

Please identify the name of the professor that you had for the course the second time that you enrolled:

In detail, please explain why you were unsuccessful in passing the course above:

If you need to provide further information, please use the space below:

If your appeal is approved, what would you do going forward to make sure that you pass the course? Please explain below:

If you need to provide further information, please use the space below:

Thanks for submitting the course approval form. We will be in contact soon!

Submit

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