Appeals Form

  mm/dd/yy
Please describe the reasons for your academic performance. Please provide as much information as you think necessary for the Appeals Committee to best understand your situation. Research has shown that use of alcohol and/or drugs may have an impact on academic success. In your response, please include a discussion of the impact, if any, of the use of alcohol and drugs on your academic performance.

Indicate how the problems have been addressed so there is reason to believe they will no longer affect your academic performance.

Please indicate the source and type of supporting documentation you will be submitting.