To Be Completed by the Student in Black Ink

Satisfactory Academic Progress Appeal Form

To be completed by the Student in black ink

Name: Matric #
Address: City, State, Zip:
Telephone: Email Address:
Degree Program: Trimester/Quarter:

Federal regulations require students to maintain Satisfactory Academic Progress (SAP) in four areas to retain financial aid eligibility: Cumulative Grade Point Average (GPA), Cumulative Pace (Credit Hour Completion), Maximum Time Frame, and Academic Standing. It is the student’s responsibility to stay informed of the College’s SAP standards and to monitor his/her own progress.

In some cases, a student’s failure to be in compliance with one or more areas of SAP is due to extenuating circumstances beyond the student’s control. If such circumstances can be documented, the student may submit this completed SAP appeal form along with all required supporting documentation. Submission of the appeal does not guarantee approval. If the appeal is denied the student is responsible for any balance owed to the College.

1. Please check the reason(s) for the appeal:

My cumulative GPA has dropped below 2.0 (3.0 for Master’s)

My cumulative pace (credit hour completion rate) is less than 67%

I have (will) exceed the maximum time frame

I am on Academic Warning, Academic Probation, or Academic Management Contract.

2. Please check your circumstance(s). You must provide supporting documentation.

Circumstance for Appeal / Supporting Documentation
□ Serious medical illness or injury / Signed doctor’s statement on office letterhead
□ Death of an immediate family member / Death certificate; obituary or announcement indicating your relationship
□ Clinic class failure / Letter from staff doctor outlining clinic qualities
□ Other special circumstance / Specific to the circumstance

3. Write your appeal letter and document your case. At a minimum, the following items should be included:

  Explanation of the deficiency

  Why you became deficient – your extenuating circumstances

  How you plan to resolve (or have resolved) the deficiency – how have/will you overcome these extenuating circumstances so that satisfactory academic progress will be met after the completion of the next term?

4. Submit all items to the Office of Financial Planning by the deadline specified in your notification email.

Certification: I certify the information on this Satisfactory Academic Progress Appeal Form, my written appeal, and any supporting documentation are accurate, true, and complete to the best of my knowledge. I will provide other information as requested by the Financial Aid Appeals Committee. I realize that a final decision may not be made on my Satisfactory Academic Progress appeal unless all steps above are complete and until I submit any additional information if requested by the Financial Aid Appeals Committee. I understand any false information may be cause for the denial, reduction, and/or repayment of student financial assistance and a charge of misconduct will be filed with the College.
Student Signature Date
This section will be completed by the Financial Aid Appeals Committee:
Cumulative Attempted Credit Hours ______Cumulative Completed Credit Hours ______Pace
Cumulative GPA ______Academic Status ______
Committee Decision:
Approved ______Denied ______Signature ______Date

Palmer College of Chiropractic ▪ Office of Financial Planning ▪ www.palmer.edu/FinancialAid

satisfactory academic progress appeal form.doc Page 2 9/29/2016

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satisfactory academic progress appeal form.doc Page 2 9/29/2016