UNIVERSITY DISCIPLINE COMMITTEE - APPEAL FORM
Return completed for
m by email to marcia.yoshida@umanitoba.ca
Telephone: 204-474-6166 Fax: 204-474-7511
Mr. Ms. Dr.
NAME (APPELLANT): U OF M STUDENT NO.:
(if applicable)
MAILING ADDRESS:
Street, City, Province, Postal Code
TELEPHONE: EMAIL:
Home / Cell / Business
FACULTY/SCHOOL
Will you be accompanied by a spokesperson? Yes No
Will this spokesperson be a lawyer? Yes No
NAME OF SPOKESPERSON: POSITION:
MAILING ADDRESS:
Street, City, Province, Postal Code
TELEPHONE: EMAIL:
Business / Cell
Hearings shall be closed unless you request in writing at least 48 hours prior to the proceeding that the hearing be open. If the
hearing is open, reasonable seating for spectators shall be provided, but spectators may not participate in the proceeding.
Please indicate Disciplinary Authority:
Please state what you are appealing:
Findings: Penalty: Both:
Signature of Appellant Date
This personal information is being collected under the authority of The University of Manitoba Act and it will be used to process your appeal. The personal
information that you provide will be used only the purpose for which it is collected, unless you consent or we are authorized to do so under The Freedom of
Information and Protection of Privacy Act (FIPPA). If you have any questions about the collection of your personal information, contact the Access and Privacy
Office (Tel: 204-474-9462), 233 Elizabeth Dafoe Library, University of Manitoba, Winnipeg, MB R3T
2N2.
CLEAR FORM
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