SUSPENSION APPEAL REQUEST
Name:______________________________________ Student Number (A#):________________________
Major:______________________________________ Advisor:___________________________________
Phone:______________________________________ Email:_____________________________________
Address:___________________________________________________________________________________
Student’s Signature:____________________________________________ Date:____________________
Instructions:
Complete the Suspension Appeal Request form in full. Attach supporting documentation that validates your
mitigating circumstance(s) (e.g., medical documentation, obituary, etc.). You may email the completed form and
supporting documentation to admissions@gadsdenstate.edu
, mail to GSCC Admissions Office, PO Box 227,
Gadsden, AL 35902-0227, or bring to the One Stop Center – Admissions and Records Office. The appeal form
must be received by the applicable deadline notated in your Academic Standing correspondence email.
What circumstances prohibited you from meeting Academic Standards?
Please explain what changes have occurred that will enable you to meet Academic Standards in the future?
(USE BACK SIDE IF NEEDED)
Rev: 01/20
G A D S D E N S T A T E
C O M M U N I T Y C O L L E G E
