Office of the University Ombuds

Program Dismissal Appeal: Student Information Form

Program (required)

Department (required)

Date of Dismissal (required)

Statement from student (required)

Why do you believe you should not have been dismissed from the program? (required)

What is your understanding as to why you were dismissed from the program? (required)

What steps, if any, have you taken to resolve this dismissal prior to appealing to GAPDAC? (required)

Student contact information

Name (required)

Email (required)