FOR GRADUATE STUDENTS ONLY
A
PPLICATION FOR READMISSION (ON APPEAL)
FOR ________________
Semester Year
Name: _______________________________________________________________________
Last First M.I. W#
Address: _________________________________ College: ______________________
Degree: ______________________
_________________________________ Major: ______________________
City State Zip
Obtain the following information from the most recent grade report or from the transcript.
GPA Hours Hours Quality
Attempted Earned Points
Last semester totals: __________________________________________
Overall totals: __________________________________________
Number of dismissals at graduate level: ___________
Have you filed a previous appeal? Yes ________ No _______
INSTRUCTIONS
APPLICATION MUST BE APPROVED NO LESS THAN THIRTY DAYS PRIOR TO
BEGINNING OF SEMESTER.
Since you failed to meet the scholastic requirements set forth in the Catalogue, you are not
eligible for readmission until the time limitations have been met and an appeal approved.
First dismissal: must remain out one semester, appeal, and be approved.
Second dismissal: must remain out one calendar year, appeal, and be approved.
If you wish to appeal: (1) Complete this form
(2) Provide all supporting documentation you deem necessary
(3) Submit to your Graduate Coordinator
(4) Request an interview if appropriate
Attach a short narrative, listing circumstances that prevented you from being academically
successful. Document if necessary. Outline plans for successful academic work.
TO BE COMPLETED BY GRADUATE COORDINATOR OR DEPARTMENT HEAD
Name: ________________________________________ W#____________________
College: __________________ Degree: _________ Major: _________________
1. Interview with student? Yes: ____________ No: ____________________
2. Recommend readmission? Yes: ____________ No: ____________________
3. Justification for recommendation:
( ) First dismissal
( ) Student has corrected problem(s) resulting in dismissal
( ) Other
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
4. Semester recommended for readmission: _____________
Semester
5. Readmission recommendation
__________________________________________
Graduate Coordinator
__________________________________________
Department Head
__________________________________________
Academic Dean
__________________________________________
Director of Graduate Studies
_________________
Year
_________________
Date
_________________
Date
_________________
Date
_________________
Date
Rev. 12/18