SENATE COMMITTEE ON APPEALS – APPEAL FORM
Return completed form by email to marcia.yoshida@umanitoba.ca
Telephone: 204-474-6166 Fax: 204-474-7511
Mr. Ms.
NAME (APPELLANT): U OF M STUDENT NO.:
(if applicable)
MAILING ADDRESS:
Street City/Province Postal Code
TELEPHONE: EMAIL:
Home Cell/Business Fax
FACULTY/SCHOOL (RESPONDENT) DATE OF LAST APPEAL LEVEL 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
INDICATE THE GROUNDS FOR APPEAL – See Section 2.5 of the Senate Committee on Appeals Policy
failure of the Faculty/School or Dean/Director to follow procedures
failure of the Faculty/School or Dean/Director to follow the rules of natural justice
failure of the Faculty/School or Dean/Director to reasonably consider all factors relevant to the decision being appealed
that a Faculty/School/Senate governing document has become inapplicable through lapse of time or was unfairly applied
that there is an apparent conflict between a Senate governing document and a Faculty/School governing document
failure of Senate, the Faculty/School, or Dean/Director to comply with applicable legislation
CLEARLY SPECIFY THE REMEDY YOU ARE SEEKING:
YOU MUST INCLUDE:
• A letter to the Chair clearly explaining the grounds for the appeal
• A copy of the letter of decision from the last appeal level
• A copy of all of the documentation submitted to the last appeal level
(new documentation cannot be submitted at this time)
• The names of any witnesses, recognizing that calling them is at the discretion of the Chair
The Committee shall decide whether to hear the appeal in open or closed session taking into account the preferences
of both the Appellant and the Respondent. Indicate your preference: OPEN
CLOSED
Do you give permission for your Academic Transcript to be distributed to the Committee: YES NO
By signing this form, I acknowledge that I have read the Senate Committee on Appeals Policy and Procedures.
http://umanitoba.ca/admin/governance/governing_documents/students/senate_committee_on_appeals_policy.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 academic 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.
