Updated 07/30/18
Carrington-Scott Campus
STUDENT SUCCESS
PO Box 8000
Graham, NC 27253-8000
Veteran Certification Appeal Form
The standards of progress associated with Veteran benefits (maintenance of satisfactory attendance and
satisfactory academic progress) are found in the ACC General Catalog. Please complete the information
below.
Full Name: ___________________________________________________________________
Date of Birth: _________________________
Student ID #: _________________________
Semester in which student is requesting VA certification appeal: ______________________
Type of Appeal: (check one)
____ Unsatisfactory Attendance (Withdrawals)
____ Unsatisfactory Academic Progress (GPA)
Part I: Explanation/Documentation of Mitigating Circumstances
Please describe in detail the mitigating circumstances that led to the unsatisfactory academic progress
or withdrawals (attach documentation as necessary):
Part II: Action Plan
Please describe in detail your action plan for future academic success. (Ex: Meetings with ACC success
coaches or academic advisors, use of tutoring services, time management strategies, changes in
personal life, decreased workload, etc.)
Signature: ___________________________________________________ Date: _________