Contact Department Head

If you want to appeal a grade please see Grade Appeal Procedure. Complete informal process step 1 as stated on the Grade Appeal Procedures page prior to contacting Department Head.

Student Information

Student Name (First, Last)

Student ID Number

Email Address

Course Information

Degree Program/Catalog Code (ex. Marketing, 125)

Catalog Year Major Declared (ex. Fall 2015-2016)

Class (ex. BA-103)

Class Section Number (ex. 1389)

Day(s) and Time Class Meets (ex. MW, 10-12 p.m.)

Professor

Your Academic Advisor/Counselor

Details of Contact Request

Details of question, comment or concern

What is your desired outcome?

Confidentiality

I acknowledge that this form is not confidential and will be shared with the appropriate parties involved.

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