THE UNIVERSITY OF TEXAS AT SAN ANTONIO
Course Reinstatement Petition
For Instructor Drops Only
It is the obligation of the student to make a serious effort to resolve grievances concerning an instructor-initiated
drop resulting from failure to meet the attendance and/or missed assignment requirements as specified on the
course syllabus. Appeals, therefore, will not be considered at levels above the course instructor unless there is
compelling evidence of discrimination, differential treatment, factual error, or violation of a relevant university
Appeals must be submitted to the academic department office offering the course no later than 3 business
days after official notification has been sent to you that you have been dropped from a course for
excessive absences and/or missed assignments.
___Yes the faculty member has been contacted and a serious effort to resolve the matter has been made.
PLEASE TYPE OR PRINT LEGIBLY
Name__________________________________________ Student ID #____________________
Email___________________________________ Phone Number ________________________
Course Name & Number _______________________________________ Section___________
State specifically the basis for the appeal of the drop citing specific factors that you feel meet one of the
conditions above, and provide all supporting documents.
Return the completed form to the academic department/associate dean’s office responsible for offering the
Student’s signature__________________________________ Date: __________________
Approved _____ Disapproved______
Chair or Associate Dean’s Signature____________________________Date____________
Route to Registrar’s Office, Attn: Records