ACADEMIC STANDARDS APPEAL

Appeal for Reinstatement to UW-Whitewater

Student instructions for filing an appeal:

  1. Complete all sections of the appeal form and save as a new Word document. The Academic Standards Appeals Committee will not consider incomplete appeal applications.
  2. Academic Standards requires that appealsbe e-mailed as an attachment to the Academic Standards email account. Inability to submit the appealby e-mailis not an acceptable reason not to meet the appeal deadline. Students with a disability that prohibits them from completing and emailing an appeal form should contact the Academic Standards office.
  3. Appeals must be received by the appropriate deadline—late appeals will not be accepted.
  4. You may submit additional sheets to provide further explanation, letters of recommendation, copies of medical records, or other documentation in support of your appeal. These forms must be submitted electronically as an email attachment to the Academic Standards email account.

Note: Students have the ultimate responsibility of knowing their grades, academic standing, and deadlines for all appeals.

Appeals should be returned to: will receive a confirmation email from the Academic Standards Office.

Personal Information

/ Date: / / /
Name:
Last Name / First Name / MI / ID #
Home Address:
Street
City / State / Zip
Home Phone: / () - / Cell Phone: / ()-
Campus E-Mail: / Other E-mail:

Academic Information

Last Term Attended(fall/spring/summer & year):

College of Major:Arts Communication Business & Economics Education Letters Sciences

Major: Minor:

Major Advisor: Other Advisor:

Last Term GPA: Cumulative GPA: Number of Completed Credits:

Did you take courses at another institution after being dismissed?

If yes, have you sent your official transcripts to UWW?

If yes, have you applied through the Admissions Office for re-entry to UWW?

Please fill in information regarding your use of the following Tutorial Services:

Check the tutorial
program(s) you used / Indicate Classes
Supplemental Instruction
Writing Lab
Math Lab
Business Center
Tutorial Center

Please mark all academic/student support programs you are involved in:

Center for Students with Disabilities

Counseling Center

Academic Support Services (indicate one)

Minority Business/Teacher Preparation

Native American Support Services

Southeast Asian Support Services

Academic Network

Latino Student Program

Other:

Involvement Information

List and describe your involvement and participation in extra curricular activities such as: seminars, internships, jobs, student government, conferences, student organizations, sororities/fraternities, athletics, residence hall activities and/or others:

Academic Deficiency

Please explain your assessment of the reason for academic deficiency:

Please explain the steps you intend to take to correct your academic deficiency: