Camp Community College – Student Grade Appeal

This form is to be completed by students submitting an appeal of a final course grade under the Formal Procedure explained in the College Catalog and Student Handbook. Please complete all sections of the form and attach the requested documents and any additional documentation you would like the committee to consider as part of your appeal. Submit this form and documentation to the appropriate Academic Dean.

* Indicates a required field.

Student Information

Name

7-digit Student ID Number

Student E-mail

Phone Number

Course Information

Course

Course Section

Instructor

Grade Being Appealed

Reason for Appeal

My grade was assigned in a manner other than that listed in the course syllabus, or as listed in an amended syllabus provided by the instructor. Please attach a typewritten explanation and a copy of the syllabus for the course.
My grade was assigned in a manner other than that used for other students in my class. Please attach a typewritten explanation and a copy of the syllabus for the course.
Other. Please briefly describe below, and attach a typewritten explanation and a copy of the syllabus for the course:

Student Signature:

Date:

For Office Use Only

Dean's Signature:

Date:

VP A&SD Signature:

Date:

Forwarded by VP to Committee:

Date: