Student Petition Instructions
The Student Petition Process provides students with a process to request a grade change from D, F, or U to a withdrawal without refund (W grade)
or D, F, U or W grade to an administrative withdrawal with a 100% refund due to documented extenuating circumstances. Extenuating
circumstances, are those determined to be exceptional and beyond the control of the student (based on Policy IV-35 Student Appeal of Course
Withdrawal and Forgiveness Limitations, Full Cost of Instruction Assessment, and an Appeal/Approval Process and Procedure 4018 – Student
Petitions.
Petitions for withdrawal without refund (W grade) or administrative withdrawal with 100% refund must be submitted no later than the end of the
following major term. A student must complete this form and attach all required documents supporting the extenuating circumstances that negatively
affected his/her attendance and/or progress in one or more course(s) at Miami Dade College. Examples of extenuating circumstances and required
documentation for the purpose of this petition are as follows:
•
Illness/injury/death to the student or family member (including but not limited to parent, sibling, significant other, spouse, child,
grandparent):
‐
Letter on official hospital letterhead signed by the attending physician stating the illness/injury and the services provided, as well as
related dates. The illness/injury must have occurred during the term for which this petition is sought.
‐
If the student suffered an accident, an official report of the occurrence, such as a police report, should be submitted.
‐
In the case of death, a copy of obituary/death certificate naming the deceased and/or proof of the student’s relationship.
•
Work schedule change or relocation of employment:
‐
Letter on official company letterhead signed by the employer/supervisor indicating student’s original work schedule, effective date of
schedule change, and the new work schedule.
‐
If the student was hired, terminated or relocated during the term for which the petition is sought, then the letter must state effective
date of employment, termination, or relocation.
•
Jury duty or direct involvement by the student with current legal action:
‐
Official record or written statement signed by the clerk of jury duty or legal action. Divorce documents and/or court records must also be
submitted if warranted.
•
Student called to active duty or reserves: Copy of military orders.
•
Relocation of student. Documentation showing new address.
Guidelines:
Guidelines for the Petitions Committee are provided in the Student Rights and Responsibilities webpage and in Procedure 4018 – Student Petitions.
In appropriate circumstances, the Student Dean is authorized to make exceptions to the financial and academic procedures of the College without a
formal committee process, subject to applicable laws.
ATTENTION: IF YOUR RECEIVED FINANCIAL AID, THERE MAY BE FINANCIAL REPERCUSSIONS TO THIS PETITION.
Please check your individual case with the Financial Aid Office on your campus before proceeding. Once the Petitions Committee approves
the petition, the Office(s) of Financial Aid, Veteran & Military Services and/or International Students will be notified.
NOTES: Administrative withdrawal with refund eliminates the course and associated grade for that term from the student’s academic transcript.
The number of credits enrolled may fall below the minimum required for financial aid, so students receiving financial aid may have to refund the
College if the student’s petition for withdrawal is approved. Students who have never attended one or more of their registered course(s) or have
stopped attending all of their courses may also owe money to the College. Since Virtual College classes are online 24/7 globally, only specific
circumstances that prevented students from accessing coursework will be accepted. Students must provide specific documentation about how they
were prohibited from accessing their coursework online.
Instructions: (Use the web browser CHROME to fill out form)
1.
READ, COMPLETE, PRINT, SIGN, AND DATE the petition. COMPLETE a separate petition for each term you are requesting
committee action.
2.
SUBMIT a signed, dated letter explaining how the extenuating circumstances affected your ability to complete the course(s) successfully.
If you continued attending any course(s) during the term, you must explain how that/those course(s) was/were not affected by
your extenuating circumstances.
3.
PROVIDE documentation specified above for the term for which the petition is sought. Documentation dates must correspond to course(s)
dates in order for the documentation to be considered. Petitions without appropriate documentation will not be considered.
4.
MAIL or DELIVER the original completed package to the Student Dean’s Office at the campus where the course(s) was/were
taken. You should KEEP A COPY of the completed petition package for your own records.
Rev. 7/17/2018
