Fill - Free fillable Academic Suspension Appeal Form (Laramie County Community College) PDF form

Suspension Appeal Form 18-19 Page 1 of 2

Academic Suspension Appeal Form

Instructions: Complete this form including all required signatures. Incomplete forms will not be considered for

appeal

and will be denied. A complete appeal packet includes additional forms completed with an LCCC advisor.

Expl

anation of Academic Performance

Part I: Please answer the following questions, providing enough detail to fully explain any extenuating

circumstances.

1. Academic Suspension occurs after two consecutive semesters of your cumulative GPA falling

below a 2.0. What were the factors that caused you to experience such academic performance?

2. Wha

t has changed related to the above issues and what adjustments have you made/will you

make to ensure a more successful academic performance next semester?

Name:

LCCC ID #:

Mailing Address:

City/State/Zip:

LCCC Email:

Phone #:

Term of Suspension:

Date:

Program of Study:

Advisor:

Suspension Appeal Form 18-19 Page 2 of 2

Part II: Meet with an Advisor from Student Planning and Success for assistance in completing this part.

3. List and describe at least three proposed actions that you will take if your appeal is granted that

will put you back on track to getting your GPA in good standing:

Part III: By signing below, I understand that:

I am appealing my current Academic Standing of Suspension and asking to be extended another

semester of Probationary Status.

The decision of the Suspension Appeal Committee, based on this information, is final.

If my appeal is not approved, I am required to sit out the next semester from LCCC and then may

return to courses with a Probationary Status.

If my appeal is approved, I am required to comply with all conditions outlined by the Appeal

Committee and my advisor.

Student Signature: ________________________________________________ Date: _______________

Advisor Signature: _______________________________________________ Date: ________________

A completed appeal packet can be turned in to the Student Hub located in the lobby of the Clay

Pathfinder Building in Cheyenne or the lobby of the Laramie Campus, or sent to Office of the

Registrar, 1400 E. College Drive, Cheyenne WY 82007.

You will receive notification of the committee’s decision through your student email.

Fill Online, Printable, Fillable, Blank Academic Suspension Appeal Form (Laramie County Community College) Form