SUSPENSION APPEAL PETITION

Office of the Registrar

SUSPENSION APPEAL PETITION

DATE TERM

NAME ID NUMBER

(Last), (First)

E-Mail

CURRENT LOCAL ADDRESS:

STREET PHONE NUMBER

CITY STATE ZIP CLASSIFICATION

PERMANENT ADDRESS:

STREET PHONE NUMBER

CITY STATE ZIP

Please print clearly your justification for appealing your suspension. Include supporting information, which details all aspects of your appeal.

For official use only:

Date Received_________________________ Action Taken ___________________________________________

Advisor’s Name_________________________________ Major ________________________________________

Current GPA _______________ Number of Hours Attempted ______________ Completed _________________