Third Attempt Appeal

To appeal for a third attempt of a course, please email your completed form to the UW Flexible Option Enrollment Services Office at registrar@uwex.wisconsin.edu. Your appeal will be reviewed by the Academic Director, and you will be notified of a final decision by email. Please note that appeals are reviewed on specific days of the month; therefore, you may not receive a decision until after the next subscription period enrollment deadline. We encourage you to submit your appeal as soon as possible to meet all deadlines. Please reach out to your Success Coach (SC) with questions about the appeal process.

"*" indicates required fields

Name*

First Middle Last

Campus ID*

Success Coach Name*

University Email*

Phone Number*

Degree/Certificate Program*

Select Degree/Certificate ProgramAssociate of Arts & Science (Liberal Arts)Business Administration, Bachelor's DegreeDiagnostic Imaging, Bachelor's DegreeHealth Care InformaticsHealth Sciences, Bachelor's DegreeInformation Science & Technology, Bachelor's DegreeNursing (RN to BSN), Bachelor's Degree

Course Name/Number*

For example: NURS 407X – Foundations of Nursing Practice

1st SP (first attempt at course)*

Month

Year

Grade Earned

2nd SP (second attempt at course)*

Month

Year

Grade Earned

Intended 3rd Attempt*

Month

Year

Steps for Appeal Letter

1. Reflect on the reasons you were not able to successfully complete your course within your first 2 attempts.
2. Describe the extenuating circumstances that prevented you from finishing the course, and what steps you will take to be successful if approved for a third attempt.
3. Identify specific resources or tools you will use to successfully complete your course.

Appeal Letter*

Supporting Documents

If you have any supporting documents you'd like to attach, please upload them here.

Drop files here or Select files

Max. file size: 64 MB.

Student Signature*

Date*

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