Los Angeles Harbor College 1111 Figueroa Place Wilmington CA 90744 (310) 233-4090
PETITION FOR GRADE REVIEW
LAST NAME FIRST NAME STUDENT ID NUMBER DATE
ADDRESS PHONE NUMBER
SEMESTER/YEAR COURSE NAME SECTION INSTRUCTOR GRADE GRADE
TAKEN
& NUMBER NUMBER RECEIVED REQUESTED
All items above must be filled in before petition will be reviewed. Please explain fully your reasons for requesting this grade review.
READ PROCEDURES ON REVERSE SIDE OF THIS PAGE. Use an extra sheet of paper if necessary.
________________________________________________
Student’s Signature
↓ FOR OFFICE USE ONLY ↓
TO INSTRUCTOR: Please indicate your decision below and forward the petition to your Division Chairperson.
No change is authorized Change grade in above course to ___________
REASON:_____________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
(See reverse side of this page)
_____________________________________________ ____________________
Instructor’s Authorization Date
________________________________________________________________________________________________________________________
_____________________________________________ ____________________
Division Chairperson Review Date
_____________________________________________ ____________________
Dean of Academic Affairs Approval Date
_____________________________________________ ____________________
Final Processing by Admissions Date
FOR ADMISSIONS OFFICE USE ONLY
Initials & Date: _________________
Petition Number:_______________
Notice to Student:______________
BASIS FOR GRADE CHANGE UNDER THE STATE EDUCATION CODE
76224. (a) When grades are given for any course of instruction taught in a community college district, the grade
given to each student shall be the grade determined by the instructor of the course and the determination of the student’s
grade by the instructor, in the absence of mistake, fraud, bad faith, or incompetency, shall be final.
PETITIONS FOR GRADE REVIEW MUST BE FILED WITH THE ADMISSIONS AND RECORDS OFFICE
WITHIN ONE YEAR FROM THE LAST DAY OF THE SEMESTER IN WHICH THE DISPUTED GRADE
WAS AWARDED.
GRADE REVIEW PROCEDURES
STUDENT
1. The student must pick up and return the PETITION FOR GRADE REVIEW to the Admissions Office.
2. The student must fill out (TYPE OR WRITE LEGIBLY) all parts above the “FOR OFFICE USE ONLY” line.
Failure to fill out all petition items will prevent any further processing of the petition.
3. The student must complete a separate petition for each grade to be reviewed.
4. PETITIONS SUBMITTED TO THE INSTRUCTOR FIRST WILL NOT BE ACCEPTED.
5. The student will be notified by mail of the action on this petition.
6. All PETITIONS FOR GRADE REVIEW, both approved and denied, will be placed in the student’s file.
ADMISSIONS
7. The Admissions Office will review this petition to determine if it has been properly filled out by the student.
8. Admissions will forward petition to instructor for approval or denial and attach a Grade Change Form, a copy of
the Permanent Attendance Roster, and/or a copy of the Grade Collection Form.
INSTRUCTOR
9. The instructor must state in writing the reason for approval or denial.
10. The instructor will forward the signed petition to the Division Chairperson for review.
11. The Division Chairperson will forward the signed petition to the Dean of Academic Affairs for approval.
12. The Dean of Academic Affairs will forward the signed petition to the Admissions Office for final processing.