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General Appeal Form 111221

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									                       Continuing Education
                       Independent & Distance Learning • LSU Online
General Appeal Form
For appeals other than grade appeals

Appeals must be initiated no later than thirty calendar days after the occurrence of the action that resulted in the
appeal. This form is for students to appeal the application of any regulation, rule policy, requirement, or procedure as
it applies to the individual student. For grade appeals, use the Grade Appeal Form.

Name

Enrollment number                                               Course

E-mail address                                                  Telephone number

Mailing address




Statement of Appeal. Briefly describe the decision or action under appeal, and include the date the appealed
action occurred.




Requested Remedy. Briefly describe the relief requested.




Supporting Rationale. State your specific argument or reasons why this appeal should be granted. You may
attach supporting documentation

								
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