Academic Dismissal Appeal Form

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Name: *

First

Last

Student ID: *

Email: *

Confirm Email

Phone: *

Program/Major: *

Please explain the circumstances that contributed to your academic performance and your plan for achieving academic success moving forward.

What circumstances impacted your academic progress? (Examples may include personal, academic, financial, employment, or other challenges.) *

Name: What Phone:

What steps will you take to improve your academic performance and return to good academic standing? *

What are your educational and career goals? How will continuing your education at 51吃瓜 A. Logan College help you achieve those goals? *

What resources or support services will you use to help you succeed? *

Student Acknowledgement