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Request for Dismissal Administrative Review
Request for Dismissal Administrative Review
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Form Instructions:
Please fill out the following form to request an administrative review of your dismissal status. A review can be requested if there were late grade replacements submitted, late change of grades filed, or another substantial change was made to your record after academic action was assigned for the term. You may submit the request up to 10 business days after receiving the dismissal email.
This not an appeal.
If the administrative review is approved you will be placed on Notice of Dismissal.
10 Digit NSHE ID
If you are an Academic Advisor submitting this on behalf of a student, list their name below.
Please select from the following which academic action was taken:
Grade Replacement
Change of Grade
Improper Withdrawal/Refund Appeal
Other
If you selected other, please provide a brief statement below regarding the academic action that was processed.
Term (ex. Fall 2022)
Please list the class or classes the academic action was pertaining to (EX: MATH 126).
By initialing below you acknowledge you have read and understand the above statements.
Other Fields
Your name
Your first name
Your last name
Your email address
Verification Code