You are on page 1of 1

PetitiontoAppealaPD200905Decision(AcademicYear200910)

Yourpetitionwillnotbeprocessedifyouarenotusingthecurrentform.Pleasecheck
http://www.sjsu.edu/advising/forms/tobecertainthatyouareusingthemostrecentversion.Unlessthereare
extenuatingcircumstances,thispetitionmustbesubmittedwithin30daysofnotificationoftheoriginal
decision.ThispetitionissolelytoappealdecisionsmadeundertheImplementationGuidelinesforthe
PresidentialDirective200905(http://www.sjsu.edu/advising/presidential_directive/).Thesedecisionsinclude:
Guideline1ApplyingforGraduation(requiringstudentstodoso)
Guideline2RestrictingEnrollmentOptions(enrollmentonlyforclassesleadingtograduation)
Guideline3DeclaringMajors(requiredby60units;admissionrestrictionshavebeenapplied)
Guideline4ChangingMajors(unitand/oradmissionrestrictionshavebeenapplied)
Guideline5FailuretoMakeAcademicProgress(leadingtoAdministrativeAcademicProbationor
Disqualification)
Guideline6ChangingGraduatePrograms(restrictionsonchangingoraddingprograms)

SJSUID

Name(print)

Phone(cellpreferred)

StudentSignature

Emailaddress

Major

PleaseindicateYESorNOforeachoftherequireditemsforsubmissionofacompletedpetition
YES
NO
RequiredItems:
Thisisthecurrentversionofthepetition(http://www.sjsu.edu/advising/forms/)
Copyofdecisionbeingappealed(includingthereasonforthedenial)
Yourpersonalstatement(andoptionalsupportingevidence/documentation)
SJSUtranscript(unofficialOK)&relevanttranscripts(ifany)fromotherinstitutions
showingacademicworknotyetreflectedontheSJSUtranscript
Listofcoursescurrentlyenrolledin
Listofadditionalcourseworkrequested(withnumberofunitsandpurposefortaking)
Letterfromanadvisororfacultymembersupportingtheneedforadditionalcoursework
Page1ofyourDegreeProgressReport(undergraduatesonly)
AlltheinformationIhaveprovidedinthispetitionistruthfulandcomplete
Incompletepetitionswillnotbeprocessedunlessyouprovideanexplanationforalloftheaboveitemsthatare
indicatedNO:

STUDENTmustsubmitcompletedpetitiontotheUndergraduateStudiesOffice,Administration159.

AppealsPanelRecommendation(circleone):
Comments(optional):

PanelChairName(print)

APPROVE

DENY

Signature

APPROVE

DENY

Signature

Date

Phone

AVPordesignee,UGSorGS&R(FinalDecision):
Comments(optional):

AVP(ordesignee)Name

OTHER

Date
Version:Feb08,2010

You might also like