Petition for Readmission of Disqualified Student - SOPT
Name
*
First Name
Last Name
PNWU ID #
*
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
I certify that the information submitted in this request (including all attachments) is ture, complete, and accurate. I understand that any misrepresentation will be cause for denial of the request and possible disciplinary action.
Signature
*
Date
*
-
Month
-
Day
Year
Date
Attach a one-page typed and signed appeal to the petition explaining the circumstances of your disqualification and your potential to meet the required minimum GPA of 3.0. Provide a rationale explaining the cause(s) of your academic difficulties and how you have been able to resolve these difficulties. Indicate anything else you believe would be helpful in the consideration of your request, including supportive documentation.
Browse Files
Cancel
of
Important Notice
Students who have been approved for readmission must contact Enrollment Services for information regarding registration. All registration/add deadlines must be adhered to.
Submit
FACULTY SECTION BELOW - Students DO NOT Continue
The faculty have met with the above-named student, reviewed their academic record and disqualification status from the university. The recommendation for the semester is:
Approve re-admit
Deny re-admit
Comments
If approved, student will...
Repeat courses
Enroll in the following courses for the semester
Achieve a GPA at the end of the semester
Other (such as unit limits and/or work hours, petition for retroactive withdrawal)
Courses to repeat
Courses to enroll in the following semester
Description of Other
Program Director Signature
Signature Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: