Appeal Form

Appeal Form

The use of this form is for any student who would like to request a policy variance.
Student Name*

First NameLast Name
MTECH ID*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Petition*

MonthDayYear
Program*
Campus
Teacher/Advisor*
Email*
Variance Details*
Please provide all details and attach any documentation to be considered for determining variance. Some questions to consider: 1) What are you requesting and why? 2) What will change if this variance is approved?
Additional Documentation

Max. file size: 5MB, Max. files: 3
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Signature*

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This form is to be used to determine variances of college policies and procedures. A petition must be filed within thirty (30) days of the occurrence of the circumstance upon which it is based. All determinations are based on the submitted documentation. Any disputes regarding the determination will be addressed according to the MTECH Grievance policies and procedures.
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