SENATE COMMITTEE ON ACADEMIC ACCOMMODATION APPEALS - APPEAL FORM
Return completed form by email to marcia.yoshida@umanitoba.ca
Telephone: 204-474-6166 Fax: 204-474-7511
Mr.
Ms. Dr. TYPE OF APPELLANT: ☐STUDENT OR ☐ ACADEMIC STAFF MEMBER
NAME (APPELLANT): U OF M STUDENT NO.:
MAILING ADDRESS:
Street City/Province Postal Code
TELEPHONE: EMAIL:
Home Cell/Business Fax
DATE OF RECONSIDERATION DECISION: _________________________________
Will you be accompanied by a spokesperson? Yes No Will this spokesperson be a lawyer? Yes No
Mr. Ms.
NAME OF SPOKESPERSON: POSITION:
MAILING ADDRESS:
Street City/Province Postal Code
TELEPHONE: EMAIL:
Business Fax
Select THE GROUNDS FOR APPEAL in the appropriate section below – See Section 2.5 of the Student Accessibility Appeal
Procedure for details
IF YOU ARE A STUDENT, SELECT GROUNDS FROM THE LIST BELOW:
Failure of judgment: they believe the decision made by the Director of SAS was incorrect in his/her judgement regarding the need for,
application of, or implementation of an Accommodation.
Failure of process: they believe the decision made by the Director of SAS was incorrect due to a failure on his/her part or the part of
SAS to dutifully perform the process of determining eligibility, or determining a reasonable Accommodation.
Failure of information: they believe the determination made by the Director of SAS was incorrect due to a lack of information or
documentation. Generally speaking, the failure of information is informally handled by the student providing updated or requested
documentation.
IF YOU ARE AN ACADEMIC STAFF MEMBER, SELECT GROUNDS NOTED BELOW:
Compromising Academic Standards: they believe that the decision made by the Director of SAS would undermine Bona Fide
Academic Requirements or any essential skills document developed for programs that are subject to external accreditation. The onus is
on the Academic Staff Member to establish how the standards or essential skills would be compromised by providing the
Accommodation. If a Bona Fide Academic Requirements or an essential skills document has not been developed, no appeals shall be
available to Academic Staff Members.
YOU MUST INCLUDE:
• A letter to the Chair clearly explaining the grounds for the appeal
• A copy of the letter of reconsideration from the Director of SAS
• A copy of all the documentation submitted in regard to the request for accommodation and/or reconsideration
• If the Appellant intends to have a lawyer present at the appeal hearing, the name and address of the lawyer shall be provided at the
time of filing the appeal
By signing this form, I acknowledge that I have read the University of Manitoba Accessibility Policy, the Student Accessibility
Procedure and the Student Accessibility Appeal Procedure.
http://umanitoba.ca/admin/governance/governing_documents/students/accessibility.html
Signature of Appellant Date
This personal information is being collected under the authority of The University of Manitoba Act and it will be used to process your appeal. The personal information that you
provide will be used only the purpose for which it is collected, unless you consent or we are authorized to do so under The Freedom of Information and Protection of Privacy Act
(FIPPA). If you have any questions about the collection of your personal information, contact the Access and Privacy Office (Tel: 204-474-9462), 233 Elizabeth Dafoe Library,
University of Manitoba, Winnipeg, MB R3T
2N2.
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