Date Submitted: ______________________

NASHVILLE STATE COMMUNITY COLLEGE

STUDENT GRADE APPEAL FORM

NAME: __________________________________ STUDENT ID#____________________________

E-MAIL ADDRESS________________________ COURSE No/TITLE_______________________

INSTRUCTOR: ______________________ SEMESTER_____________ YEAR__________

Step 1. REASON FOR APPEAL AND DESIRED OUTCOME: (Student Completes)

(Use additional sheets if necessary)

Signature: _____________________________ Date: ________________________________

FACULTY RESPONSE: (Use additional sheets if necessary)

Decision: _________________________________________________________________________

Signature: ___________________________________ Date: _________________________________

(Student may appeal to Division Dean)

Step 2. DIVISION DEAN REVIEW/RECOMMENDATION:

(Use additional sheets if necessary)

Signature:__________________________________ Date:_____________________________________

Dean

(Student may appeal to Vice President for Academic Affairs or Designee)

Step 3. VICE PRESIDENT FOR ACADEMIC AFFAIRS: FINAL DECISION

Decision: _____ Sustained (Grade issued is correct) ______Convene Appeals Committee

Signature: __________________________________ Date: _________________________________

Step 4. ACADEMIC APPEALS COMMITTEE (If applicable)

Decision: ______________________________________________________________________________