Student Grade Appeal form

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					                                                          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.

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