Faculty/Staff Appeal
Faculty Name
*
First Name
Last Name
Faculty Email
*
example@example.com
I am submitting my appeal to (Email of the recipient)
*
example@example.com
College/Institute
*
Please Select
COM
COD
COP
COHS
CON
COHME
TRIPM
General Education
Department
*
Please Select
Biomedical Sciences
Clinical Science Dept
Community Medicine
Pharmaceutical Sciences
Pharmacy Practice
Physiotherapy
Anesthesia Technology
Medical Imaging Sciences
Medical Laboratory Sciences
Basic Medical and Dental Sciences
Preventive Dental Sciences
Restorative Dental Sciences
Diagnostic and Surgical Dental Sciences
Nursing Sciences
Healthcare Management and Economics
General Education
Appeal Details
*
Attachment(s) "if needed"
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