VIRGINIA WESTERN COMMUNITY COLLEGE
APPEAL OF DEAN’S ADJUDICATION
DECISION FORM
Course: Student Name:
Student EmplID:
VWCC Student Email Address:
Semester and Year:
@email.vccs.edu
Describe the incident and indicate your reason for appeal:
Sanction Imposed by the Dean of Student Services:
__ Restitution for damages
__ Reprimand or admonition
__ Suspension from college extracurricular activities
Submit your appeal electronically to the Vice President of Academic and Student Affairs from your
student email address to pcox@virginiawestern.edu or print, sign and submit directly to the office
located in Fishburn Room 125. The decision of the Vice President is final.
Subm
itted By:
________________________________________________ ___________________________
Student Date
Received by the Vice President of Academic and Student Affairs Office on: