A decision of the Administrative Hearing Officer may be appealed on the grounds listed below. Please check all that apply to your request for an appeal hearing.

Prejudicial error committeed (fair trial not received).
New or newly discovered evidence.
Sanction imposed was excessive.
Sanction imposed was insufficient.

I would like my case heard by the (please check one):

Judicial appeal board
Vice President for Student Affairs

Please explain why you belive your appeal should be considered.

First and Last Name

Date

By checking this box, I confirm that the information above is accurate.