Request for Reconsideration
A university’s decision can be reconsidered to a higher level if the student can demonstrate: (i) new evidence, (ii) the
severity of the sanction is inappropriate or (iii) a violation occurred in the process. This form must be filed and submitted
to the Enrollment Services Office (Room 203). In addition, students are required to attach any document that will support
their case.
Last Name:______________________ First Name:_________________________ Student ID:______________________
E-mail:_________________________
Home Phone: (____)_________________ Cell Phone: (___)_________________
Present Concentration/
Specialization:
Describe what you are asking the University to reconsider: (Please use an additional page if required)
Describe why you feel this reconsideration should be accepted: (Please use an additional page if required)
*Please attach copies of any relevant correspondence and/or evidence that will support your request.
TO BE COMPLETED BY RECORD OFFICE
Date Received: __________________ Clerk Initials: ______ Reviewed By: ______________________ Decision: Accepted Not Accepted
Comments: _________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
Records Updated by: _______________________________ Date: __________________
(ISP/ Scan/ File)
FDU V-Appeal Form-Dec 2018
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