The burden is on the student to demonstrate that a final course grade was assigned in an arbitrary, prejudicial, or erroneous manner. Please attach any evidence, including documents or statements, you believe supports your request for a grade change. Please provide any additional information not requested in this form that you believe is relevant to your appeal.
Received by Office of Academic Affairs
Title:
Signature _____ Date: _____
For Office Use Only □ Approved □ Denied
Date: ___