Buchanan Promise Appeal Form

Buchanan Promise Appeal Form

Eligibility, Non-Traditional Training Programs, OR Additional Funds
The Buchanan Promise Appeal Form can be used for eligibility questions due to extenuating circumstances, to request funding for non-traditional training programs, to request additional funds during the traditional school year, and to request funds for summer classes. If you believe you should be considered for eligibility due to circumstances beyond your control, please complete this form in full and submit it online. If you are requesting funding for a non-traditional training progam, please include as much information as possible about your program, including the cost of the program. If you are requesting additional funds for the traditional school year, please include the reason for your request and the amount of funds you are requesting. If you would like to take summer classes, please include the reason for taking summer classes and the amount of funds you are requesting.

To help the appeals committee review your case, please include as much detail as possible. Once the Buchanan Promise Appeals Committee has reviewed your appeal, the Program Coordinator will notify you of the decision. The review process typically takes about 30 days from the date of submission.
Student Information
Student Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Email
example@example.com
Student Phone Number
Format: (000) 000-0000.
Year of High School Graduation
Reason For Appeal Request

Note: Items that will not be considered in the Appeal Process include:
- Buchanan School District residency requirements (A Buchanan or Galien zip code does not imply automatic eligibility. Qualified applicants must live within the Buchanan School District boundaries.)

- Graduation and minimum attendance requirements (Qualified applicants must attend Buchanan Community Schools continuously during 9th-12th grade and successfully graduate.)
Reason for Appeal (select all that apply)

Other
Non-Traditional Program Enrolled In
Non-Traditional Program Cost
Non-Traditional Program Contact Name
If applicable
Non-Traditonal Program Contact Number
Please enter a valid phone number if applicable.Format: (000) 000-0000.
Non-Traditional Program Start Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Non-Traditional Program End Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit year
What school will you be attending?
Student ID Number
In 1 or 2 paragraphs, explain in detail the reasons for your appeal. Some examples would be the extenuating circumstances that result in you not meeting the Buchanan Promise eligibility criteria, why you are attending a non-traditional training program, why you need more funds in the traditional school year, or why you want to take summer courses. You should also include other information that you want the appeals committee to know (i.e. future career goals, educational plan).
Attach any relevant documentation that serves as proof of your circumstances (i.e. divorce or separation, information on the non-traditional program you are planning to attend, etc.

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I have additional files to upload
File Upload

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File Upload

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File Upload

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File Upload

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I certify that all of the provided information is true. I understand that all the information I submit with the Appeal Form will be redacted and shared with the Buchanan Promise Executive Committee Board to determine if my appeal will be granted.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Buchanan Promise Appeal Form

Student Information

Reason For Appeal Request