Fillable Student Appeal Request Form (Condential) (Langara)

Fill Online, Printable, Fillable, Blank Student Appeal Request Form (Condential) (Langara) Form

Use Fill to complete blank online LANGARA pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Student Appeal Request Form (Condential) (Langara)

On average this form takes 16 minutes to complete

The Student Appeal Request Form (Condential) (Langara) form is 4 pages long and contains:

  • 0 signatures
  • 12 check-boxes
  • 57 other fields

Country of origin: CANADA
File type: PDF

Use our library of forms to quickly fill and sign your Langara forms online.

BROWSE LANGARA FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Student Appeal Request Form (Confidential)
Important Information: Please ensure that you read and understand the following information prior to completing and
submiing your appeal.
All student appeal submissions require documentary evidence of extenuating circumstances.
Extenuating circumstances: compassionate and exceptional circumstances beyond a student’s control that significantly
affect the student’s ability to meet requirements of a course. Such circumstances may include those related to a student’s
physical or psychological health that is verifiable and documented by an appropriate professional.
All appeal requests are subject to the review and approval of the Registrar (or designate). Appeals are considered on a
case-by-case basis. Approval is not guaranteed.
It is the student’s responsibility to read and understand Policy E2011: Withdrawal from Courses and Deferred Standing (or the
relevant policy pertaining to the student’s appeal type).
Students are responsible for ensuring they are aware of all rules, regulations and deadlines to complete the withdrawal
procedure. Grounds for granting a late withdrawal are determined by the Registrar.
Examples of invalid grounds include, but are not limited to, the following:
• Not being aware of the deadline or how to withdraw
• Forgeing about the deadline
• Computer malfunction
• Anticipated poor grade in the course
• Personal convenience (including travel plans)
• Family events
• Employment circumstances
If you would like to withdraw from a course prior to the published deadline, please do so through the Student Information
System. For more information on how to withdraw from courses, please refer to the Registration Guide on the Langara
College website.
Under normal circumstances, processing time for appeals is 15-30 business days. Processing times may be longer depending
on the volume of appeals. It is the student’s responsibility to ensure that appeal requests are submied by the established
deadlines. Please be advised that late and retroactive withdrawals may affect current registration status.
Students who are receiving Government Assistance (i.e. loans, grants, etc.) should check with Financial Aid as proceeding
with this application may affect their student assistance status.
REGISTRAR & ENROLMENT SERVICES
APPEAL INFORMATION
Page 1 of 4
• I have aached official documentation of extenuating circumstances or Appendix A has been completed by an appropriate
professional as listed in Policy E2011. (For documentation not in English, I have included copies of the original documents
and official/notarized translations.)
2. REQUIREMENTS CHECKLIST
All appeal submissions require a completed appeal form, a leer of explanation, and documentary evidence of extenuating
circumstances. Please confirm that you have met the criteria outlined below before submiing your appeal.
Incomplete appeals will not be reviewed.
• I have aached a leer ex
plaining the circumstances that prevented me from meeting deadlines, the purpose of my appeal,
and a clear statement indicating my desired outcome (one page minimum).
Yes
Yes
Yes
No
No
No
• My Langara student account is in good standing (i.e. no holds/outstanding fees). Some exceptions apply. Please contact
appeals@langara.ca if you have questions.
Full legal name:
Student Appeal Request Form (Confidential)
Langara ID:
All correspondence regarding your appeal will be sent to your preferred email on file and/or your Langara email. Students
are responsible for updating their contact information in the Student Information System prior to submiing an appeal.
I confirm that my contact information is up to date in the Student Information System and that I understand all
correspondence regarding my appeal will be sent to my preferred email and/or Langara email.
3. TYPE OF APPEAL
REGISTRAR & ENROLMENT SERVICES
1. STUDENT INFORMATION
Page 2 of 4
1. Course Withdrawal (select one below and complete section 4)
Withdrawals requested aer withdrawal deadline, but before the last day of classes:
2. Other (please specify):
Complete Late Course Withdrawal – all courses in current semester are withdrawn
Partial Late Course Withdrawal – a selection of courses in current semester are withdrawn
Both the student and an appropriate professional must submit documentation that supports why one or
more courses are affected and why the other(s) are not. Doing well in one course but failing at another is
not viewed as a valid reason.
Retroactive Course Withdrawal – a complete withdrawal from all courses in previous semester(s)
Retroactive withdrawal requests will only be considered for courses students were registered in for the
previous six semesters.
Phone: Email:
Withdrawals requested aer the last day of classes of affected semester:
5. RELEASE OF INFORMATION
Langara College collects your personal information under the authority of the College and Institute Act [RSBC 1996, Chapter
52, Section 41.1] for the purpose of processing your appeal request, and in compliance with the provisions of the Freedom of
Information and Protection of Privacy Act [RSBC 1996, Chapter 165, Section 33.1]. For questions about the collection, use and
disclosure of your personal information, contact the Registrar & Enrolment Services at 604.323.5225.
By signing this document, I acknowledge that I have read and understand the information provided on this form, including
the appeal information coversheet, and I certify all my statements and supporting documents are true and complete.
COURSE SUBJECT AND NUMBER CRN INSTRUCTOR DATE OF LAST CLASS ATTENDED
Student's signature: Date (YYYY/MM/DD):
Page 3 of 4
4. COURSES AFFECTED
Fall (September)
Semester:
Spring (January)
Summer (May)
Year:
Student Appeal Request Form (Confidential)
REGISTRAR & ENROLMENT SERVICES
If appealing for more than one semester, please complete a separate appeal form for each semester.
OFFICE USE ONLY
Decision:
Comments:
Decision by: Date approved:
Processed by: Date processed:
Approved Denied Not Reviewed
6. APPENDIX A
5. How does the extenuating circumstance impact the student’s ability to aend classes and complete coursework?
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
Page 4 of 4
Student Appeal Request Form (Confidential)
REGISTRAR & ENROLMENT SERVICES
6. Comments:
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
Professional’s title:
Professional’s full name:
An appropriate professional is an Aboriginal Elder, an individual who is registered with the College of Physicians and
Surgeons of BC, a Dentist registered with the College of Dental Surgeons of BC, a registered Psychologist of the College of
Psychologists of BC, a Nurse Practitioner registered with the College of Registered Nurses of BC; or an equivalent registered
professional out of the Province.
1. How long has this student been a patient?
___________________________________________________________________________________________________________________
2. When did this student first see you regarding this extenuating circumstance?
___________________________________________________________________________________________________________________
3. In your opinion, is it necessary for the student to withdraw from all studies for the affected semester?
4. Due to extenuating circumstances, the student is/was unable to aend classes and complete coursework on the dates from:
________________________________________________________ to ________________________________________________________
Yes No
SUBMIT COMPLETED FORM AND SUPPORTING DOCUMENTATION
In person or mail to: Registrar & Enrolment Services, Langara College, 100 West 49
th
Ave., Vancouver, BC V5Y 2Z6
By email: appeals@langara.ca
Professional’s signature:
Date (YYYY/MM/DD):
STAMP OR PRINT PROFESSIONAL’S NAME AND ADDRESS:
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Student Appeal Request Form (Condential) (Langara)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 31 January 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document