Student Grade Appeal Form
You must contact your instructor to discuss your grade before you submit an appeal.
Appeals must be submitted during the 8-week session immediately following the session in which the course was taken.
Please review your student handbook for further details on grade appeals.
Student Last Name: Student First Name:
Student ID #: Person #:
E-mail Address: Phone #:
Location Attending: Home Campus:
Session/Semester of Enrollment: Course # and Section:
Course Title: Professor:
Original Grade Grade Change Requested on Appeal
A A- B+ B B- C+ A A- B+ B B- C+
C C- D+ D D- F C C- D+ D D- F
I S U Other: I S U Other:
Note: The entire body of work for this class may be reviewed. Therefore, the final grade has the potential to be increased, decreased, or
remain the same.
Reason for Change:
Miscalculation/Data Entry Error Make-Up Exam Withdrawal
Completion of Required Course Work Per Agreement Supplemental Exam
Describe why your grade should be changed:
List any documents that support your grade change (Attach all supporting documents to the completed form):
Describe your instructor’s comments on why you were not granted a grade change:
Student Signature: Date:
Send completed form to:
For Office Use Only
Form Received by: Date:
Approved Grade Granted on Appeal: Denied
Reason for Denial:
Dean Signature: Date:
DAA Signature: Date:
Adjustment Completed by: Date:
Adjustment Communicated to Dean by: Date:
University Academic Form: Student Grade Appeal Page 1 of 1
Version: V. 1.1 Supersedes: V. 1.0 June 15, 2010
In New York, DeVry University operates as DeVry College of New York. DeVry University operates as DeVry Institute of Technology in Calgary, Alberta.