75.59(A) Revised 9/20/2019
Fourth Attempt Appeal
Name: Student ID #:
Per Florida Administrative Code 6A-14.0301, a student may have only three (3) attempts per course
including the original grade, repeat grades, and withdrawals. A fourth attempt may be allowed only
through the academic appeals process based on major extenuating circumstances. Such circumstances
include, but are not limited to:
documented medical condition preventing completion;
death of an immediate family member (father, mother, sister, brother);
involuntary call to active military duty; and/or
documented change in conditions of employment.
The following circumstances are NOT considered extraordinary and extenuating, and are NOT eligible
circumstances to file an appeal:
Issues involving course content;
Issues involving method of instruction; and/or
Issues involving a lack of understanding of the withdrawal/refund policy as printed in the
college catalog & student handbook.
To petition for a fourth attempt, complete this form and submit the following required
documentation in support of your appeal:
A Letter of Explanation: please describe your major extenuating circumstance(s) that is the
reason for your appeal. Your letter must explain why you were not successful in each of the
previous attempts, and what steps you are taking to ensure success if you receive approval to
enroll in the course for the fourth time;
Copy of student bill and schedule; and
Relevant documentation: (Please select applicable documentation you are providing)
Medical-Physician’s letter on official letterhead, or other medical documents, indicating
the severity, duration, and academic impact of the condition and recovery period.
Employment-A letter from your employer, on company letterhead, indicating that your
employer changed your work schedule and that this change prevented you from
completing the term. The letter must include old and new work hours and the effective
Death (Immediate Family
ber or Guardian)- one of the following; an original death
certificate, newspaper notification, or obituary. It is your responsibility to establish your
relationship to the deceased individual.
Active Military Dut
y- must include a copy of orders.
College Change or Error-A letter from the appropriate college official documenting the
situation in which the College was in error or initiated an action that caused you to
withdraw from your course(s).