JMU Academic Appeal

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

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Date*

Date

Reason for Academic Appeal: *

All students dismissed from John Melvin University may appeal to be reinstated to the University. If you wish to appeal your academic dismissal, you must submit this form and the folliwng information/documentation within the timeline indicated:

1. An explanation of the specific circumstance that prevented you from meeting the College academic standards and how you have addressed the problem to ensure future academic success.

2. The following third party verification/documentation of the circumstances is attached.

You are required to check a box(es) below and attach documentation. If documentation is not submitted and does not support your circumstance, your appeal for reinstatement will not be reviewed.*

Death of an immediate family member (mother, father, sibling, child, spouse, or grandparent). A copy of the death certificate or obituary is required.Medical condition which resulted in the inability to attend class or make contact to drop/withdraw. Medical documentation including the dates of illness, admission to the hospital, or a signed letter from the doctor is required.Family, financial, or legal situation that impacted your ability to succeed. A statement from a third party (family member, healthcare provider, friend, faculty, or other advocate) is required.Other. Documentation of special circumstance when appropriate. Additional required documentation of steps you have already taken to address your circumstance may include, but are not limited to, a letter from your employer supporting changes in work schedule or flexibility with your school schedule, and/or a transcript from another college identifying successful completion of courses.

If your appeal is approved and reinstatement granted, you are obligated to meet the requirements of your success plan. Your plan will be evaluated at the end of the next term of enrollment to ensure that you meet all requirements. If your appeal is denited, you will be informed of your re-entry options. All committee decisions are final.

Program Enrolled in at Time of Dismissal*

New Program of Interest if Reinstated*

Month/Year of Dismissal from JMU*

Is this your first appeal?*

YesNo

If No, Term of Previous Appeal:

Describe the circumstances (death of an immediate family member, medical condition, family, financial, or legal situation) that may have contributed to your academic difficulties and attach documentation to support your circumstances.*

If your circumstances are categorized as "OTHER", describe WHY these circumstances contributed to your academic difficulties. Describe and provide documentation of the steps you have taken to improve your opportunity to achieve your educational goals at JMU. Documentation of steps you have already taken to address your circumstance may include, but are not limited to, a letter from your employer supporting changes in work schedule or flexibility with your school schedule, a transcript from another college identifying successful completion of courses, or any other documentation you think may be helpful to your appeal.

Identify and list a minimum of three items in your self evaluation that you believe will help you manage life circumstances and improve performance in your classes if reinstated to the University. *

Identify and list a minimum of three campus resources you will use to assist you in identifying solutions and overcoming barriers if reinstated to the University. *

How will the changes described above increase the likelihood that you will succeed if given another opportunity? Please be very specific and detailed in your response.

File Upload*

Signature*

Date*

Date

Appeal Approved or Denied (reasons why):