Fillable B1-StudentGradeAppealForm Student Grade Appeal no security.pdf

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B1-StudentGradeAppealForm Student Grade Appeal no security.pdf

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Pasadena City College
Student Grade Appeal
Student Name:
Last
M.I.
First
Student ID#:
E-mail Address:
From whom are you requesting a grade change?
Instructor:
Division:
Class: Section #: Semester Taken
What grade did you receive?
What grade did you feel you deserved?
Briefly state your reasons for requesting a grade change. Be sure to attach any supporting documentation.
I certify that this information is correct to the best of my knowledge.
Signature of Complainant
Date Signed
In order for the Vice President of Instruction to respond to the student within the established deadline,
please return this completed form within 10 class days to room C231.
Appendix B1
Rev 11/2011
1 of 1
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B1-StudentGradeAppealForm Student Grade Appeal no security.pdf

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Completed 24 February 2020

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