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ATENEO LAW SCHOOL

Rockwell Center, Makati City


APPEAL FORM
(With recommendation of the Students Appeals Committee)
I.
PRELIMINARIES
APPELANTS NAME: ____________________________________ STUD. NO: _______
CONTACT NUMBER: ____________________________________ YEAR and SEC: ____
II.
SUBSTANTIVE MATTERS
SUBJECT APPEALED and SECTION: _________________________________________
PROFESSOR: __________________________________________________________
___________________________Semester _________________________School Year
BREAKDOWN OF GRADE
Recitation ________ Midterm Grade ____ Final Exam _______ FINAL GRADE _____
Other Basis Declared by the Professor: ______________________________________
GROUNDS FOR APPEAL
[
[

]
]

Mathematical Error in Computation of Grades


Manifest Oversight in Correction of Written Examinations

III. BACKGROUND DATA


PRESENT STATUS:
[ ] REGULAR [
STATUS in the APPEALED SEMESTER
[ ] REGULAR [

] PROBATION

] FOR DISMISSAL

] PROBATION

QPI in the APPEALED SEMESTER: __________


SCHOLAR:
[ ] YES
[ ] NO
SUBJECT WITHOUT GRADES YET
____________________ unit (s)
____________________ unit (s)
OTHER SUBJECTS FAILED THIS SEMESTER
____________________ Grade: _____
____________________ Grade: _____

____________________ unit (s)


____________________ unit (s)

____________________ Grade: _____


____________________ Grade: _____

PAST ACADEMIC PERFORMANCE


QPI in the Previous SEMESTER: _________
ON PROBATION LAST SEMESTER:
ON PROBATION ANYTIME BEFORE LAST SEMESTER

[
[

]
]

YES
YES

[
[

]
]

NO
NO

_______________________________
SIGNATURE OF APPELANT STUDENT
IV.
SAC CERTIFICATION
The STUDENTS APPEALS COMMITTEE has reviewed the appeal of the above-indicated
appellant student and
[
[

] DENIED for reason that ____________________________________________


] Recommends that the same be given due course
______________________
CHAIRMAN
Date:

______________________
REVIEW HEAD
Date:
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ATENEO LAW SCHOOL


Rockwell Center, Makati City
APPEAL

FORM

V. ACTION SECTION
1. Action by the Standards Committee
[

DENIED
Reasons: _____________________________________________

____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
[

REFFERED TO PROFESSOR _______________________________________

DATE: ________________________
2. Action by Professor

____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
3. Final Recommendation of the Standards Committee

____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

By:
ATTY. JACINTO D. JIMENEZ
Chairman

_______________________
Member

Date:

Date:

_________________

_________________

4. Action of the Dean

____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
Date:

_________________
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