YOUR DETAILS         

Notice of Appeal

Family Name: 	Student ID No#: 	_
First Name(s):  	_
Course Name: ________________________________Course Code:___________________
Lecturers name:                                                                    Class Number:	_
Postal Address:  	_
Phone (daytime): 	Mobile Phone:  	_
Email Address:  	
The best way for us to contact you in relation to this appeal is::
	 Email
	
             Phone

YOUR APPEAL
(Attach additional pages if necessary)

What is your appeal about?
 (please tick relevant box)
1.	Appeal an outcome of an Academic Grievance on: 

Final grade
SAC decision
Award of a qualification
Enrolment in or admission to a Programme or Course 
Progression in a Programme
Exclusion from any course work or assessment
2.	Appeal an outcome of a Student Disciplinary Investigation decision

3.	Appeal an outcome of a Student Complaints Resolution decision

Please tell us what you have already done to resolve this matter.

	
Grounds for appeal (please tick relevant box)
Outcome of an Academic Grievance or Student Complaint
In the case of either an Academic Grievance decision or an outcome from a Student Complaints Resolution decision, please tick the relevant box below to indicate the grounds for your appeal

Additional information has become available which had not been, and could not reasonably have been, available at the time the original decision was made

There has been unfair process/procedure employed in reaching the original decision 

NOTE: supporting notes and/or documents must be attached to support these grounds

Outcome of a Student Disciplinary Investigation
In the case of an appeal of an Outcome from a Student Disciplinary Investigation please tick the relevant box below to indicate on which grounds you are appealing

That the procedure used for investigating or resolving the Prohibited Conduct was unfair or biased.
That the decision of the Investigator could not reasonably be sustained on the evidence.
That significant new evidence which was not previously available has become available since the investigation which could have a material effect on the decision made or the penalty imposed; and/or
That the disciplinary action/s taken were out of proportion to the nature of the Prohibited Conduct and the full circumstances of the case.

Please give us details regarding the grounds for appeal (Please use a separate sheet of paper if necessary). 

Supporting Evidence

Please attach copies of any documents that might help us investigate your appeal, or tell us how any documents or evidence can be obtained

THE OUTCOME(S)

What would you like to see as an outcome?

VERIFICATION

I confirm that I have completed this form, or have overseen the completion of the form, and that the contents are true and correct to the best of my recollection.

Signature of student:  	

Date:  	

Please email your appeal to: resolutions@unitec.ac.nz