Enrollment Services, July 15, 2015. Page 1 of 2
Academic Suspension Appeal
Submission Instructions
This form allows students to appeal Academic Suspension at Black Hawk College. In order to review your appeal request,
you must provide all of the requested information below and write the minimum number of words required, using
complete sentences. Please return this completed form to Registrar@bhc.edu, or in person at the Enrollment Services
Office, by the appeal due date indicated in your suspension letter. The Registrar will convene a committee including
representatives from the Advising Department, faculty, and Student Affairs, to review your appeal. The Registrar will
notify you of the outcome of your appeal within 10 business days.
__________________________________ _________________________________
First Name Last Name
Student ID Number
Explanation for My Academic Performance (minimum 250 words)
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My Detailed Plans for Improving Academic Performance (minimum 250 words)
Why I think I can succeed academically at Black Hawk College (minimum 250 words)
By signing this Academic Suspension Appeal form, I acknowledge that this is an appeal, and an outcome in my
favor is not guaranteed.
Student Signature *Signature line may be left blank, and e-signature will
be accepted when completed form is sent from a student’s myBHC
email account.
Enrollment Services, July 15, 2015.