Petition for Appeal

Indicates required field

Appeal Request

First Name

Last Name

PID

Ohio Email

Phone Number to be Used for Appeal Board Meeting

Additional Attendee Information

Students can have a parent, guardian, or other party present at the appeal meeting. The student must be present and cannot be represented by another person. In addition, if a student does not attend their scheduled appeal board meeting, the board will review the request in their absence.

Additional Attendee Name

Additional Attendee Relationship to Student

Additional Attendee Phone Number

Appeal Information

Basis of Appeal

New Documentation

Further Explanation of Situation

Other (Please Explain Below)

Reason for Appeal

Reason for Appeal
	Reason for Appeal	Item weight

more items

Upload additional supporting documents

Unlimited number of files can be uploaded to this field.
10 MB limit.
Allowed types: jpg jpeg png pdf doc docx xls xlsx zip.

I certify that my reason for making this request are true and understand that falsification of any material submitted in support of this exemption request is a violation of the Student Code of Conduct.

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