Fillable Form 1.: ACADEMIC SUSPENSION APPEAL FORM For Undergraduate (Northwestern State University)

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Form 1.: ACADEMIC SUSPENSION APPEAL FORM For Undergraduate (Northwestern State University)

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1
YOU WILL BE NOTIFIED BY TELEPHONE OR E-MAIL FROM THE DEAN’S OFFICE REGARDING THE STATUS OF YOUR APPEAL.
APPEALS RECEIVED AFTER THE DEADLINE OF THE LAST DAY for REGULAR (16 week) OR
B-TERM (8-WEEK) REGISTRATION FOR THAT SEMESTER WILL NOT BE CONSIDERED BY THE ACADEMIC DEAN.
LATE ACADEMIC APPEALS WILL NOT BE ACCEPTED
****** FINANCIAL AID APPEALS ARE NOT RELATED TO ACADEMIC SUSPENSION APPEALS ******
ACADEMIC SUSPENSION APPEAL FORM
For Undergraduate Students
Revised 11-09-21
Northwestern State University policy allows a student with mitigating circumstances to appeal suspension from the University.
DIRECTIONS TO STUDENT:
1.
Complete this Appeal Form in its entirety.
2.
Explain the basis of the appeal for readmission to NSU in a typed letter. Describe the circumstances that contributed
to your current academic performance. Explain what you will do differently to improve your academic standing this
semester. Attach the letter to this Appeal Form.
3.
Schedule a meeting with your academic advisor or department head.
4.
Obtain a statement for the appeal request from your academic advisor or department head. The statement is to either
support or deny the request. If the request is supported, the Re-Admit Contract for Suspended Students, with terms/
conditions, must be included with the Appeal Form and Student Appeal Letter. If the appeal request is not supported b
y
t
he academic advisor or department head, reasons must be provided for denying the student’s appeal request.
5.
All academic appeal materials (appeal form, appeal letter, and statement of support/denial from the academic advisor or
department head) will be submitted to the appropriate Dean’s Office (see page 3) by the last day of regular registration.
The appeal materials may be EMAILED, FAXED, or HAND-CARRIED to the DEAN’s OFFICE.
Include contact information below.
CONTACT INFORMATION:
Student Name CWID Date
CURRENT ADDRESS AND PHONE NUMBERS
Address
City
College (see pp. 3-4)
Department (see pp. 3-4)
State
Zip
Major
Cell #
Land #
Advisor
Advisor Email
NSU Email Address: @nsula.edu
Signature of Student Date
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2
RE-ADMIT CONTRACT
To be completed by ACADEMIC ADVISOR or DEPARTMENT HEAD
Previous Appeals: (dates)
Last Semester Enrolled
Semester GPA
Cumulative GPA
Statement provided by Advisor or Department Head (provided as an attached document)
Action taken by Advisor or Department Head: Approved
Denied
Advisor or Department Head Signature
Date
TERMS AND CONDITIONS for RE-ADMISSION
To be completed by ACADEMIC ADVISOR or DEPARTMENT HEAD and STUDENT and signed by the Student.
I will enroll in a minimum of hours and a maximum of hours this semester.
I will earn at least a 2.0 GPA this semester or a minimum GPA set by my academic advisor or department head (GPA: ).
I will meet with my assigned academic advisor at least two times this semester.
I will schedule an appointment with my academic advisor by (date set by the advisor or department head).
I will schedule an appointment with my academic advisor or department head after the posting of my midterm grades.
After mid-term grades are posted, I am responsible for meeting with my assigned academic advisor for advising and
registration for the following semester.
I will attend a minimum of two Student Success Workshops presented by the Academic Success Center (ASC).
(Schedule to be provided by the ASC.)
Other requirements, such as study hall hours, tutoring, or prescriptive course schedule:
I understand I must fulfill the conditions of this contract as stated above.
Student’s Signature Date
To be completed by the DEAN
ACTION TAKEN BY DEAN: Approved for semester Denied
DEAN’S RESPONSE:
Dean’s Signature
DIRECTIONS TO DEAN:
Submit all appeal materials to Academic Advising Services (email, fax, or hand-carried).
Suite 112 Watson Memorial Library
|
318-357-4399 Fax
|
academicadvising@nsula.edu
Date
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3
College of Arts and Sciences; Scholars’ College
|
Dean: Dr. Francene Lemoine
Location: Caspari Hall Room 128
|
Phone: 318-357-4330
|
Fax: 318-357-4255
|
Email: lemoinef@nsula.edu
College of Business and Technology
| Dean:
Dr. Mary Edith Stacy
Location: Russell Hall Room 201
|
Phone: 318-357-5161
|
Fax: 318-357-5990
|
Email: maryedith@nsula.edu
ACADEMIC MAJORS by departments and colleges are listed below. You will be responsible for contacting your academic
ad
visor or department head who will review your academic appeal materials (appeal form and appeal letter). Following your
advisor or department head’s recommendation, all appeal materials will be submitted to the appropriate College Dean’s office for
approval. You will be notified by your College Dean (or designee of the Dean) of the final decision for your appeal request.
Department
Major
Department Head, Director, or Coordinator
School of Biological and
Physical Sciences
Applied Microbiology, Biology,
Pre-Professional Programs,
Physical Sciences, Veterinary
Technology
Dr. Christopher Lyles
•
112C Bienvenu Hall
318-357-5323
|
lylesc@nsula.edu
School of Social Sciences
and Applied Programs
Criminal Justice, History, Unified
Public Safety Administration
Dr. Mark O. Melder
•
103 Kyser Hall
318-357-5499
|
melderm@nsula.edu
Engineering Technology
Electronics Engineering
Technology, Industrial
Engineering Technology
Dr. Jafar Al Sharab
•
102 Williamson Hall
318-357-6751
|
jafar@nsula.edu
English, Foreign Language,
and Cultural Studies
English
Dr. James Mischler
•
318B Kyser Hall
318-357-6272
|
mischlerj@nsula.edu
Mathematics
Mathematics
Dr. Frank Serio
•
431 Kyser Hall
318-357-4308
|
serio@nsula.edu
School of Creative
and
Performing Arts
Communication
Dr. Jie (Jessica) Zhang
•
239 Kyser Hall
318-357-6166
| zhangj@nsula.edu
Fine and Graphic Arts
Ms. Leslie Gruesbeck
•
205B New Fine Arts
Building 318-357-6560
| gruesbeckl
@nsula.edu
Music
Ms. Terrie Sanders
•
213S Creative & Performing Arts Bldg
318-357-5762
|
sanderst@nsula.edu
Theatre & Dance
Mr. Brett Garfinkel
•
101S Creative & Performing Arts Bldg
318-357-5793
|
garfinkelb@nsula.edu
Other Degree Offerings
General Studies, Liberal Arts
Mr. Steve Hicks
•
112 Eugene P. Watson Memorial Library
318-357-6950
|
hickss@nsula.edu
Scholars’ College
Liberal Arts
Dr. Thomas Reynolds
•
110 Morrison Hall
318-357-4577
|
reynoldst@nsula.edu
Department
Department Head, Director, or Coordinator
School of Business
Accounting
Dr. Curtis Penrod
•
114E Russell Hall
318-357-5033
|
penrodc@nsula.edu
Business Administration
Dr. Curtis Penrod
•
114E Russell Hall
318-357-5033
|
penrodc@nsula.edu
Computer Information Systems
Dr. Curtis Penrod
•
114E Russell Hall
318-357-5033
|
penrodc@nsula.edu
Hospitality, Management, and
Tourism
Ms. Connie Jones
•
132 FACS Building
318-357-5587
|
jonescl@nsula.edu
4
College of Nursing and School of Allied Health
|
Dean: Dr. Joel Hicks
Location: Shreveport Campus: 1800 Line Avenue, Shreveport, La
Phone: 318-677-3073
|
Fax: 318-677-3127
|
Email: hicksj@nsula.edu
Department
Major
Department Head, Director, or Coordinator
Health and Human
Performance
Health and Exercise Science,
Health and Physical Education
Grades K-12
Dr. Tara Tietjen-Smith
102 H&HP Building
318-357-5103
| tietjensmitht@nsula.edu
Psychology
Addiction Studies, Psychology
Dr. Susan Thorson-Barnett
333 Bienvenu Hall
318-357-6594
|
barnetts@nsula.edu
Social Work
Social Work
Dr. Ruth Weinzettle
149 Kyser Hall
318-357-5491
|
weinzettler@nsula.edu
School of Education
Child and Family Studies;
Early Childhood, Grades PK-3;
Elementary Grades 1-5; Secondary
Grades 6-12; Instrumental Music
Education K-12; Vocal Music
Education K-12; Instrumental &
Vocal Education K-12.
Dr. Katrina Jordan
B-115 Teacher Education Center
318-357-6144
|
jordank@nsula.edu
Department
Major
Department Head, Director, or Coordinator
School of Allied Health
Allied Health; Radiologic Sciences
Dr. Kelli Haynes
403 Nursing Education Center, Shreveport
318-677-3100
|
haynesk@nsula.edu
College of Nursing
Nursing
Dr. Anna Morris
433 Nursing Education Center, Shreveport
318-677-3100
|
morrisa@nsula.edu
Gallaspy College of Education and Human Development | Dean: Dr. Kimberly McAlister
Location: Teacher Educ. Center, Pod B, Rm B103 | Phone: 318-357-6288 | Fax: 318-357-6275 | Email: mcalisterk@nsula.edu
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Form 1.: ACADEMIC SUSPENSION APPEAL FORM For Undergraduate (Northwestern State University)

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Completed 22 December 2021

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