Fillable OFFICE OF STUDENT LIFE, RM D-101 ACADEMIC APPEAL (CUNY Hostos Community College)

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OFFICE OF STUDENT LIFE, RM D-101 ACADEMIC APPEAL (CUNY Hostos Community College)

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OFFICE OF STUDENT LIFE, RM D-101
ACADEMIC APPEAL FORM
PERSONAL INFORMATION
Last Name: ______________________________ First Name: ____________________________
Address:_____________________________________________________________________________
City: _____________________ State: _____________ Zip Code: ______________________
Home Phone: ( ______) ________-________ Cell Phone: (______) ________-____________
Work Phone: ( ______) ________-________ Email Address: ________________________________
CUNY First ID#: _______________________ Major: _____________________ Date: _________
Appeal Type: Fall/Spring Academic Appeal
(Active students who are currently registered and seeking permission to register for
the following semester due to an academic stop)
Re-admission
(Inactive students who have not been enrolled for one semester or more and where
academically dismissed from the college)
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PERSONAL STATEMENT
Provide a statement explaining any unusual circumstances for poor academic performance. Attach another
sheet if necessary.
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ACADEMIC PLAN
In a paragraph or more, provide a plan of action identifying the steps to be taken for improving
academic performance? For example, counseling, tutoring, # of credits you wish to register for next
semester, courses, etc. Also include # of courses remaining to complete your degree program and
how you plan to finance your education (i.e. financial aid, out of pocket, reimbursement, etc.) Attach
another sheet if necessary.
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SUPPORTING DOCUMENTS
Please submit any medical/other supporting documents (if applicable) to support the appeal. These
documents can be submitted directly to the Office of Student Life, Room C-330 so copies of the documents can
be made. Only supporting documents will be accepted at the office. Your written appeal must be submitted
via email to ensure an immediate response.
APPEAL SUBMISSION
All appeals must be submitted via email at academicappeals@hostos.cuny.edu. Please refer to the Academic
Appeal/Re-admission Fact Sheet for deadlines. If you have any questions, you may contact the Office of
Student Life at (718) 518-6557.
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OFFICE OF STUDENT LIFE, RM D-101 ACADEMIC APPEAL (CUNY Hostos Community College)

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Completed 21 September 2020

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