General Student Petition
General Student Petition
1
General Student Petition
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Form Survey
Full Name:
Full Name:
*
First
Middle
Last
Student ID# G00:
*
IVC Email:
*
Contact Number:
Contact Number:
*
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I HEREBY PETITION FOR THE FOLLOWING
*Please fill out one petition per request.
1.
1.
ACADEMIC DISMISSAL APPEAL
A student has the right to appeal a proposed dismissal action if the student feels that facts exist that warrants an exception to the dismissal action. The student must file the written petition of appeal to the Admissions & Records office within 10 instruction days after the dismissal notification. If the student fails to file a written petition within 10 instruction days, the student waives all future rights to appeal the dismissal action.
Upload written statement as to why the appeal is being requested and supporting documentation to verify your statement.
Attach Files
2.
2.
CATALOG RIGHTS
Requesting to Retain Catalog Rights for the YR
(Student must have active application and have completed all courses for degree for requested catalog year):
3.
3.
EARLY FINALS (Pre-approval from your instructor is required)
Instructor's Name:
Course CRN (e.g. 12345):
Test will be administered on:
Test will be administered on:
/
MM
/
DD
YYYY
4.
4.
EXCUSED WITHDRAWAL
Semester:
Fall
Winter
Spring
Summer
Year:
2021
2022
2023
2024
CRNs Requesting Excused Withdrawal:
Requires documented evidence which must be attached.
Attach Files
5.
5.
MILITARY WITHDRAWAL
Requires documented evidence of orders.
Attach Files
6.
6.
PETITION APPEAL
I wish to appeal decision on previous petition.
Upload a copy of denied petition and indicate reason you wish to appeal the decision and supporting documentation.
Attach Files
Student Signature:
*
Draw
or
Type
I understand this is a legal representation of my signature.
Use mouse to sign.
Clear
Full Name
I understand this is a legal representation of my signature.
Use mouse to sign.
Upload your IVC Student ID or a Valid ID for verification:
*
Attach Files
Upload a statement explaining the reason for your request:
*
Attach Files