Fillable Drop Appeal Form (Alamance Community College)

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Drop Appeal Form (Alamance Community College)

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The Drop Appeal Form (Alamance Community College) form is 1 page long and contains:

  • 1 signature
  • 4 check-boxes
  • 25 other fields

Country of origin: US
File type: PDF

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H:/FORMS/ADMINISTRATIVE WITHDRAWAL REFERRAL FORM
Drop Appeal Form
Student Name: ________________________________
Student ID: _________________
Instructor Name: ____________________________________________________________
Course Prefix: _________ Weekly Contact Hours: ________
Course Number: _________ Accumulated Absences (Hours): ________
Section Number: _________ Accumulated Tardies: ________
16- Week Course 12 – Week Course 8-Week Course 5 – Week Course
Current Average in Course: _______________
Yes No Has the student exceeded the department’s attendance policy of ________
hours of the total contact hours for the semester?
Yes No Has the student exceeded the college’s attendance policy of 20% of the
total contact hours for the semester?
Yes No Has this student conducted himself/herself with professionalism and
respect in your classroom?
Yes No Are there extenuating circumstances related to the absences?
If yes, explain.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Yes No Do you recommend that this student be readmitted to your class?
Comments: ____________________________________________________________________
______________________________________________________________________________
__________________________ __________________
Instructor’s Signature Date
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Drop Appeal Form (Alamance Community College)

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Completed 29 January 2021

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