Fillable APPEAL TO EXTENUATING CIRCUMSTANCE COMMITTEE Attendance beyond the (State University of New York at Farmingdale)

Fill Online, Printable, Fillable, Blank APPEAL TO EXTENUATING CIRCUMSTANCE COMMITTEE Attendance beyond the (State University of New York at Farmingdale) Form

Use Fill to complete blank online STATE UNIVERSITY OF NEW YORK AT FARMINGDALE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

APPEAL TO EXTENUATING CIRCUMSTANCE COMMITTEE Attendance beyond the (State University of New York at Farmingdale)

On average this form takes 7 minutes to complete

The APPEAL TO EXTENUATING CIRCUMSTANCE COMMITTEE Attendance beyond the (State University of New York at Farmingdale) form is 2 pages long and contains:

  • 0 signatures
  • 4 check-boxes
  • 28 other fields

Country of origin: US
File type: PDF

U.S.A. forms for State University of New York at Farmingdale

BROWSE STATE UNIVERSITY OF NEW YORK AT FARMINGDALE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
APPEAL TO EXTENUATING CIRCUMSTANCE COMMITTEE
The procedure for requesting an exception outside of the College’s Tuition Refund Policy is available to students
when severe circumstances arise that prevented a student from attending classes for the remainder of a semester or
resulted in non-attendance of classes in which you were enrolled.
Attendance beyond the 8
th
week of the semester is not eligible for consideration by the ECC
CRITERIA FOR APPEALS:
• Severe medical issues or serious injury directly involving yourself or immediate family member
• Academic Course Error
• Student’s Military Activation
• Other: Severe/Unforeseen circumstance
GENERAL INSTRUCTIONS
1. You must officially withdraw from course(s) that you are appealing. The College cannot process your appeal if
you remain enrolled in a course(s). Non-attendance does not cancel a student’s financial liability. If you were
assigned a grade “N” (never attended) , this grade cannot be changed to a withdrawal.
2. To apply for retroactive withdrawals for a previous semester, you must first submit appeal to the Retroactive
Withdrawal Committee, Farmingdale State College, Attn: Amanda Lavery, Chair, Hale Hall Room 127,
Farmingdale, NY 11735
3. Complete the refund request form: refund request form must be completed in its entirety.
4. Attach supporting documentation and typed detailed statement.
a. Typed detailed statement why you were unable to complete semester. Submitted by you (the student);
(not a third party, unless legally assigned).
b. Supporting documentation should include extenuating circumstance which occurred during
the semester that prevented you from attending classes for the remainder of a semester or from
attending classes in which you were enrolled, the severity and length of circumstance(s) and must
be in official document format. A final decision is made based on supporting documentation. Additional
information will NOT be accepted.
5. Request must be addressed to: Farmingdale State College, Extenuating Circumstances Committee,
Dean of Students-Laffin Hall Room 314, 2350 Broadhollow Road, Farmingdale, NY 11735-1021
GENERAL GUIDELINES
6. A request for tuition credit must be submitted no later than one year after the end of term in question. For
example, a student requesting a tuition credit for the Spring semester must submit their request before the end of
the following Spring semester. Appeals received after the deadline will not be honored.
7. Drop/Add refund dates are widely publicized. Therefore, appeals based on lack of awareness of the dates will not
be accepted.
8. Non-attendance does not cancel a student’s financial liability. An extenuating circumstance explaining non-
attendance must be submitted; if appeal is approved an administrative cancelled registration fee will be assessed.
9. The Committee will communicate its decision in writing. The Committee’s decisions are final. The Committee
does not, under any circumstances, take phone calls or schedule appointments. Allow six to eight weeks.
10. If your appeal is approved, you will receive a pro-rated refund of tuition based on the withdrawal date or last date
of attendance.
Appeals will be DENIED without completed request form, supporting documents and student’s typed statement.
REFUND REQUEST FORM
PLEASE READ THE APPEAL INSTRUCTIONS AND TUITION REFUND POLICY BEFORE COMPLETING FORM.
Student Information:
Name:
Student ID/”RAM” number
Current Mailing Address
(if your address is different from your previous student records, you must submit a change of address form with your appeal)
Phone
E-mail
List all courses you are requesting a credit for: (use additional forms as needed)
CRN/Department/Section/Title
Credits
Semester/Year
Last Date of Attendance/Date of Withdrawal
Reason and Rationale: Check One and MUST attach your Typed Statement of Justification explaining the grounds of your
appeal and provide Supporting Documentation as necessary. Appeals will not be reviewed without supporting documents and
typed statement.
 Student’s Medical Situation
immediate family member. MUST submit a signed doctor’s official letterhead
statement, to include: dates, medical condition, length of treatment, and how
illness/injury prevented you from attending classes for the remainder of a
 An Academic Course Error Submit all documentation possible to support your statement; include student
copies of official college administrative documents and/or letter from faculty
 Student’s Military Activation Submit a copy of military activation orders signed by commanding officer.
 Other Circumstance
remainder of a semester or resulted in non-attendance of classes in which you
were enrolled, i.e. death in family, MUST be supported with official
If the circumstance meets any of the above, the following must also be met:
• Application must be made within one year after the end of term in question.
• Attendance cannot exceed beyond the 8
th
week of the semester. If a student’s last date of attendance is beyond 8
th
week of the
semester, the case is not eligible for consideration by the ECC.
• The student must be officially withdrawn before application is submitted.
Student Accountability Statement: To the best of my knowledge, all of the information on this form and attachment(s) is complete
and accurate. I understand that the Committee’s decision is final.
_______________________________________________________________________________________________________
Student Signature Date
Mail Application and Supporting Documentation to: Farmingdale State College, Extenuating Circumstances Committee,
Dean of Students-Laffin Hall Room 314, 2350 Broadhollow Road, Farmingdale, NY 11735-1021
As the Committee consists of personnel from several sections of the campus, telephone calls regarding appeals cannot be accepted.
The Committee reviews appeals throughout the academic calendar year. Allow six-eight weeks for the Committee to review your
appeal and respond. The decision of the Extenuating Circumstance Committee is FINAL. For information regarding the ECC process:
Email
ECC@farmingdale.edu
Submit to Registrar's Office Laffin Hall Room 225 OR regoffice@farmingdale.edu
You may submit your request and supporting documentation to ECC@farmingdale.edu
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

APPEAL TO EXTENUATING CIRCUMSTANCE COMMITTEE Attendance beyond the (State University of New York at Farmingdale)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 1 October 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document