UC/GS 03/18
THE UNIVERSITY OF TEXAS AT SAN ANTONIO
STUDENT ACADEMIC AND GRADE
GRIEVANCE FORM
It is the obligation of the student to make a serious effort to resolve grievances concerning grades or other academic
concerns or incidents with the student’s faculty member. The faculty member has the primary responsibility for assigning
grades. Appeals of grades, therefore, will not be considered at levels above the faculty member unless there is evidence
of discrimination, differential treatment, factual error, or violation of a relevant university policy. For an allegation of
discrimination or if a grade appeal contains an allegation of discrimination, the faculty member or Department Chair must
notify the student to contact the Equal Opportunity Services (EOS) office and the administrator must also contact EOS to
report the student’s claim. The student may simultaneously file a discrimination complaint with the EOS office. If there is a
foundation for the discrimination complaint, EOS will notify the appropriate administrator to place the academic and grade
grievance on hold until an investigation has been completed. Once the investigation has been completed, EOS will notify
the student and the administrator of the outcome. Based upon the outcome, the academic and grade grievance review
process will continue or be closed. (See Academic and Grade Grievance Procedure in the Information Bulletin.)
IN NO CIRCUMSTANCES WILL GRADES BE CHANGED AFTER ONE CALENDAR YEAR.
INSTRUCTIONS
The student must first contact the faculty member and make a serious effort with the faculty member to resolve the
matter. If the student is unsuccessful in resolving the matter with the faculty member, the student must complete this
form and may appeal the grade or academic grievance to the Department Chair. The student may appeal the decision
of the Department Chair to the Dean of the faculty member’s college, and then, if an undergraduate student, to the
Dean of the University College, and if a graduate student, to the Dean of the Graduate School.
Yes No The faculty member has been contacted and a serious effort to resolve the matter has been made.
Yes No The Department Chair has been contacted and has provided written notification of his/her decision.
Yes No The Dean of the College has been contacted and has provided written notification of his/her decision.
PLEASE TYPE OR PRINT LEGIBLY
Student’s Name Student’s ID Number Major
Address City State/Zip Preferred Email Address Telephone
Faculty Member’s Name Course/Section (include semester course was taken)
State specifically the academic concern, academic incident, or grade(s) being appealed, and the action
requested.
Explain the basis for the appeal citing factors other than disagreement with a judgment of the faculty
member or administrator and provide all supporting documents. (Attach additional pages if necessary for
explanation.)
Return the completed form to the Department Chair, and then, if appealing the Department Chair’s decision, send the form to
the Dean of the College; finally, if appealing further, send the form to the University College for undergraduate students or to
the Graduate School for graduate students. Written decisions will be sent to the address shown above or emailed to the
student’s preferred email address.
Student’s signature: _______________________________________ Date: ________________________
With a few exceptions, you are entitled on your request to be informed about the information U.T. San Antonio collects about you. Under Sections 552.021 and 552.023 of the
Texas Government Code, you are entitled to receive and review this information. Under Section 559.004 of the Texas Government Code, you are entitled to have U.T. San
Antonio correct information about you that is held by us and that is incorrect, in accordance with the procedures set forth in The University of Texas System Business
Procedures Memorandum 32.
