Owens Community College
Academic Misconduct Appeal Form
Student Name ____________________________ OCID ___________________________________
Address ___________________________________________________________________________
Telephone Number _____________________________________ Date ________________________
I am requesting a review of my grade for the following (check) ____ course _____ assignment:
Complete one form for each course/assignment for which you are requesting a review:
Course and section number ____________________ Instructor: _____________________________
Credit Hours: ________ Term/Date Taken: Fall ________ Spring _________ Summer _______
In compliance with the academic appeal procedure I have met with each of the following individuals
involved in the grade review process.
Informal Process:
Step 1: Meet with faculty member ____________________________ ______________
(Instructor name) (date)
Step 2: Meet with Department Chair ___________________________ _______________
(Department Chair’s name) (date)
Step 3: Meet with the School Dean ___________________________ _______________
(School Dean’s name) (date)
Formal Process – Informal process must be complete before the formal process with the Vice Provost
can occur. Students should complete this form and submit it to the Office of the Vice Provost for review.
I am requesting review of an academic dishonesty charge
____ Procedural error
____ New evidence
____ Sanction was not in proportion to the charge
Step 4: Meet with the Vice Provost ___________________________ _______________
Signature: __________________________ Date: ____________________
Attach a letter providing a full explanation as to why you are requesting a review of your grades. Attach all
supporting documentation that you wish to be reviewed in support of your request.
