National Park College
Request for Academic Record Review
From the NPC Academic Catalog: Any student who feels a grade has been recorded in error has until the end
of the
following semester, excluding summer sessions, to notify the Registrar's Office.
STUDENT NAME: ________________________________________________ NPC ID: _____________________
MAILING ADDRESS: ____________________________________________________________
HOME PHONE:
__________
CELL OR WORK PHONE: ______________
Please describe your concern and the action you want taken (include as many specifics as possible, such as
the
semester and year a course was taken, course title, instructor name, etc.):
Attach any supporting documents such as copies of registration or drop forms, medical records, or instructor
notations. Submit to the Registrar's Office for review. You will receive written notification of the decision.
By submitting this f
orm I certify that the information on this form is true and correct.
---------------------------------------------------------------------------below for office use only------------------------------------------------------------------------
FINAL RECOMMENDATION:
___Withdraw ___
Expunge ___
Refund Tuition ___Refund Fees ___
Request Denied
Other
:
Registrar's Signature
Date
Revised 07/2015
If unable to submit form online: please print, sign, and return to NPC Registrar.
Signature: ________________________________________________ Date: _____________
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