75.59(C) revised 9/20/2019
Third Attempt Appeal
Name: Student ID:
Florida Administrative Code 6A-14.0301 places responsibility for the full cost of instruction (out-of-
state tuition) on the student after the second attempt of a course. The legislation also provides students
the opportunity to appeal for a one-time exception, per course, to the increased fees for cases involving
major extenuating circumstances beyond the student’s control. Such circumstances include, but are
not limited to:
serious illness;
documented medical condition preventing completion;
death of an immediate family member (father, mother, sister, brother);
involuntary call to active military duty;
documented change in conditions of employment;
other circumstances are those required by a regulatory agency. Courses may be repeated if
they are required to be repeated by a regulatory agency, or are being repeated as part of a
regulatory requirement for continuing education to stay current in a field, such as teacher
certification; and/or
financial hardship: The exception for financial hardship may be granted only after the
student has demonstrated reasonable effort to succeed in the class.
The following circumstances are NOT considered extraordinary and extenuating, and are NOT
eligible circumstances to file an appeal:
Transportation issues;
Issues involving course content;
Issues involving method of instruction; and/or
Issues involving a lack of understanding of the withdrawal/refund policy as printed in the
college catalog & student handbook.
To petition for a third attempt, complete this form and submit the following required
documentation in support of your appeal:
A Letter of Explanation: please describe your major extenuating circumstance(s) that is the
reason for your appeal. Your letter must explain why you were not successful in each of the
previous attempts, and what steps you are taking to ensure success if you receive approval
to enroll in the course for the third time;
Copy of student bill and schedule; and
Relevant documentation: (Please select applicable documentation you are providing)
Medical-Physician’s letter on official letterhead, or other medical documents, indicating
the severity, duration, and academic impact of the condition and recovery period.
75.59(C) revised 9/20/2019
Name: Student ID:
Employment-A letter from your employer, on company letterhead, indicating that your
employer changed your work schedule and that this change prevented you from
completing the term. The letter must include old and new work hours and the effective
Death (Immediate Family Member or Guardian)- one of the following; an original death
certificate, newspaper notification, or obituary. It is your responsibility to establish your
relationship to the deceased individual
Active Military Duty- must include a copy of orders.
College Change or Error-A letter from the appropriate college official documenting the
situation in which the College was in error or initiated an action that caused you to
withdraw from your course(s).
Other Circumstances: Other circumstances are those required by a regulatory agency.
Submit documentation that supports the regulatory agency requirement and your
statement(s) in your letter.
Financial Hardship: The exception for financial hardship may be granted only after the
student has demonstrated reasonable effort to succeed in the class. Explain how paying
the full cost of instruction impacts your financial circumstances. In determining your
financial need, you should include the following: employment hours per week; where
you obtain the funds for your educational costs (work, savings, other); student status
(full-time or part-time); number of dependents, whether you are receiving Federal need-
based financial aid.
Complete the information below for the course(s) which you are appealing the full cost of tuition (out
of state tuition) due to extenuating circumstances:
Course Title Course Prefix Course # CRN (5 digits)
Deadline: NO APPEAL will be considered AFTER the first day of classes for the semester this
exception is applicable.
I understand that:
When taking any course for the third time, I may not exercise the option to withdraw, but
must complete the course and be assigned a grade, as specified in SBE Rule 6A-14.0301. I
also understand that “students who withdraw or fail a class due to extenuating circumstances
may be granted an exception only once for each class” (FS 240.124)
Appeals received without proper documentation will be returned and not reviewed until proper
documentation is provided to the Committee and this could jeopardize the timeliness of the
Committee’s decision.
It is my responsibility to monitor my FKCC email account for any correspondence from the
committee regarding this appeal.
The Committee has the right to seek relevant input regarding this appeal from other college
departments, including instructors, and use this information in their decision-making.
75.59(C) revised 9/20/2019
Name: Student ID:
If I am receiving financial aid, military assistance, veterans’ benefits, or am an international
student, it is my responsibility to check with the appropriate office to determine if this request
will affect my benefits or status.
I accept the decision of the Student Services Appeals Committee as final and not subject
to further appeal within the college.
By signing below, I certify that I have read and understand all of the information on this form. I
further certify that all statements and documentation provided by me in support of this appeal are
truthful and representative of the facts concerning the extenuating circumstance(s).
Students signature: Date:
Submit your request for consideration to:
FKCC Student Services Appeals Committee,
College of the Florida Keys,
5901 College Road, Key West, FL 33040
Phone: (305)809-3292 Fax: (305)292-5163
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