Academic Appeal Package Submission

Academic Appeal Package Submission

For disputing MARKED ASSIGNMENTS ONLY.
Full Name*

First NameLast Name
What is your student ID number?*
What school do you attend? (e.g. WSAT)*
Please provide your student email:*

Confirmation Emailfirstname.lastname@oldscollege.ca
I confirm that I have read the Student Disputes, Complaints, and Appeals Process (required).I have attempted to address the complaint directly with the instructor involved. It is expected that most issues can be resolved through discussion held in good faith (required).I am submitting this form within 10 days of the grade-related decision (required).
I have contacted my Associate Dean regarding questions or support navigating the academic dispute process (optional, but recommended).
Please provide the course code and numbers:*
What date did the course begin?

MonthDayYear
Date
What date does the course end?

MonthDayYear
Date
What is the name of the instructor of this course?*

First NameLast Name
Please provide a brief summary outlining the dispute and your intended resolution:*
Please provide any further supporting documentation or explanatory files here (optional):

Cancelof
Please attach the unchanged assignment as it was originally submitted:*

Cancelof
Please attach the marking rubric(s) or answer sheet(s) for the assignment if it has been provided to you:

Cancelof
It is the responsibility of the student to ensure that all documents are correct.

By submitting this form, you acknowledge that you have reviewed the current Procedure I07 - Student Disputes, Complaints and Appeals. You also acknowledge that the submission of this form represents no guarantee by the SAOC, Olds College, or any party that your request will be met, and that the decision of the Dean is final. You also acknowledge that your Administrative Fee shall only be refunded if the submission of this form results in a change of grade on the disputed assignment.

Administrative Fee*

Academic Appeals Administrative Fee

As mandated by Olds College policy and industry practice, the SAOC collects an administrative fee associated with academic appeal submissions.

$40.00CAD Quantity

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Signature*

Powered by Jotform SignClear
Should be Empty:

Academic Appeal Package Submission

It is the responsibility of the student to ensure that all documents are correct.