Appeal for Exception to Non-Academic Policy - College of Nursing and Health Innovation

The Appeal for Exception to Non-Academic Policy form allows students to appeal for an exception to a non-academic policy due to extenuating circumstances.

Students must be able to submit appropriate documentation to support their request for the appeal to a non-academic policy. Documentation should be relevant and timely to the reason seeking the appeal. Appeals submitted without documentation will not be approved.

This form is NOT for grade grievances. Students should follow the Grade Grievance Policy as outlined in the BSN Student Handbook.

All decisions of the Appeals Committee will be final.

Name Name First Last
Student ID Number
UTA Email Address
Phone Phone - ### - ### ####
Please select your program:

Please select your program: Accelerated Online (AO BSN) Campus BSN
I am requesting an exception for the following:

I am requesting an exception for the following: Admissions (Nursing and Health) Policy Upper-Division BSN Prelicensure Program Policy
Please name the specific policy you are appealing.
In the space below, please explain why you are requesting that an exception be granted to the College of Nursing and Health Innovation's non-academic policies. Please be specific and provide extenuating circumstances.
Please attach required documentation to support your request for an exception to non-academic policy. You will be able to upload up to 5 files.

Attach Files
I acknowledge that all information submitted is accurate and supports my request for this appeal. Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.