Nursing/Health Sciences
Program Appeal
Students appealing for a Nursing/Health Sciences (NHS) competitive program will only gain competitive
program consideration if the appeal is approved. An approved appeal does not guarantee acceptance into a
competitive program. If an appeal is not approved, the NHS application will not be given further consideration
and will be deemed withdrawn. Students who are appealing should submit the appeal application no later than
10 days in advance of the last day to submit a packet.
Complete the NHS Appeal application online, print, sign and submit to Student Services at the address or fax #
provided. Appeal A
pplications must include all required documentation. Failure to provide a completed appeal
application and required documentation by stated deadline will result in your request being denied. Please
review the status of these items prior to submission.
Name: ____________________________________________ Student ID: 0 __ __ __ __ __ __
Email _____________________________________________ Telephone #: ( ) _______
________
Address ________________________________________________________________________________
SECTION I: Mark the box for all Appeal categories that apply to you and provide the required information for each
category.
Grade Point Average. Your cumulative GPA is less than the required GPA.
Two or more
unsuccessful NHS course attempts. You failed two or more NHS courses.
Two or more unsuccessful NHS program attempts. You failed two or more NHS programs.
SECTION II: Please indicate the mitigating circumstances that have contributed to your inability to maintain or meet
academic progress by checking any category that applies to you. You also must follow the instructions for each checked
category.
Serious illness or injury to student or immediate family member (parents, grandparents, brothers, sisters,
spouse, or children of either the student or the student’s spouse) that required extended recovery time.
Attach a signed statement from a physician on letterhead detailing duration and extent of serious health condition
and recommendations made regarding non-attendance and explain the nature and dates of the illness or injury in
Section III.
Death of an immediate family member (parents, grandparents, brothers, sisters, spouse, or children of
either the student or the student’s spouse). Attach a photocopy of the death certificate, newspaper obituary or
funeral program and include the name of the deceased and an explanation of the deceased person’s relationship
to you in Section III.
Significant trauma in student’s life that impaired the student’s emotional and/or physical health. Attach a
signed statement from a professional counselor (psychiatrist, psychologist, clergy, etc. on letterhead detailing
duration and extent of event and any recommendation made regarding the effect the event had on academic
performance serious health condition and recommendations. Using Section III, provide a detailed explanation
regarding the specific circumstances of your condition. Please be sure to include dates and what you have done
to overcome this condition. Supporting documentation from a third party (physician, social worker, psychiatrist,
police, etc.) must also be attached.
Other unexpected documented circumstances beyond the control of the student. Using Section III, please
explain in detail the nature and dates of the unexpected circumstances. Supporting documentation must also be
provided.
April 2020
