Fillable ACADEMIC/PROGRESS DISMISSAL APPEAL PETITION (Taft College)

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ACADEMIC/PROGRESS DISMISSAL APPEAL PETITION (Taft College)

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O F F I C E O F A D M I S S I O N S A N D R E C O R D S
05/19/20 TP
ACADEMIC/PROGRESS DISMISSAL APPEAL PETITION
LAST NAME:
FIRST NAME:
A#:
EMAIL:
PHONE:
( )
LAST SEMESTER
ATTENDED GPA:
CUMULATIVE
GPA:
TOTAL UNITS
ATTEMPTED:
TOTAL UNITS
COMPLETED:
TERM:
1
I AM ON:
ACADEMIC DISMISSAL
AND
I HAVE SAT OUT FOR AT LEAST ONE ACADEMIC SEMESTER
PROGRESS DISMISSAL
I WOULD LIKE TO ATTEND WITHOUT A LAPSE OF ENROLLMENT
OR
2
I HAVE:
SUBMITTED MY ACADEMIC/PROGRESS DISMISSAL EXEMPTION AND I AM REQUESTING TO TAKE MORE THAN
SEVEN UNITS FOR THE UPCOMING ACADEMIC SEMESTER
II. ALONG WITH THIS PETITION, YOU MUST SUBMIT THE FOLLOWING DOCUMENTS BELOW:
PERSONAL STATEMENT: INCLUDE AN EXPLANATION OF YOUR PAST ACADEMIC CHALLENGES, EXTENUATING CIRCUMSTANCES IF
ANY, AND THE CHANGES YOU’VE MADE TO ENSURE YOUR SUCCESS.
ACADEMIC COMPREHENSIVE EDUCATION PLAN (MOST RECENT WITHIN 6 MONTHS)
III. SUPPORTING DOCUMENTATION
UNOFFICIAL TRANSCRIPTS, MEDICAL DOCUMENTATION (OPTIONAL), ETC.
I DECLARE UNDER PENALTY OF PERJURY THAT ALL INFORMATION ON THIS FORM AND SUPPORTING DOCUMENTATION IS TRUE AND CORRECT.
PRINT NAME:
SIGNATURE:
DATE:
OFFICE USE ONLY
COMMITTEE REVIEW DATE:
COMMITTEE DECISION:
APPROVE:
DENY:
COMMITTEE RECOMMENDATIONS:
DIRECTOR, ADMISSIONS & RECORDS SIGNATURE:
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ACADEMICPROGRESS DISMISSAL APPEAL PETITION (Taft College)

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Completed 25 July 2020

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