Student Appeal Form

Important: Before submitting this form please read through the Appeals FAQ's, refer to the Policy: Student Appeals and any other University regulations, policies and procedures relevant to your appeal.

You must complete all sections of the Student Appeal Form and attach a Written Statement.

Declaration
By lodging appeal I, * confirm that I have read and understood the relevant sections of the General Regulations and the Policy: Student Appeals and declare that all information and documentation lodged as part of this appeal is true and correct to the best of my knowledge, information and belief. I understand that the information and documentation I have provided in this application will be recorded confidentially on my Student File.
Declaration *	I confirm I have reviewed the Policy: Student Appeals and the General Regulations of the University of Notre Dame prior to submitting this appeal
Student details
Student Identification Number *
First name *
Surname *
Date of birth *
Domestic / International	Domestic International
Phone / Mobile *
Program code *	Find your Program Code and Name (Please enter the code and name of the program you are enrolled in, not the code and name of the course/s you are appealing – you should refer to the relevant course code and name in your Written Statement).
Program name *
Campus *	Broome Fremantle Sydney
School *
Appeal details
If you are unsure about the type of appeal to choose, please contact your School or the Student Appeal and Policy Coordinator before submitting your form.
Reason of my appeal *

Grounds of appeal Please enter the Grounds of Appeal for the appeal type you have chosen, as per the options stated in the *Policy: Student Appeals*. In your Written Statement, to be attached separately, please explain the reasons you are appealing on these grounds.

Uploads and Checklist
Supporting documentation Upload a max of 8 files (max 60MB total). Supported file types for upload .docx, .pdf, .jpeg. If you need to upload more than 60MB, consider emailing attachments separately to student.appeals@nd.edu.au. Any attachments must be submitted on the same time as the form.	add more
Checklist *	Please ensure that you upload your Written Statement and any supporting documents prior to selecting ‘Submit'. Written statement Relevant evidence Other supporting documents may include - any relevant evidence that supports your appeal, medical or otherwise (if any); and/or - a copy of the correspondence notifying you of the decision you are appealing (if any). If you are having difficulty attaching your supporting documents you should still submit the form, however, you may email the attachments separately to student.appeals@nd.edu.au.

The information provided in this form will only be used for the administrative or educational purposes of the University, or in accordance with your specific consent. The University will not disclose your personal information to a third party unless required to or permitted by law or where you have consented to the disclosure. Information relating to how the University collects, uses or discloses your personal information and how you may complain about the University’s handling of your personal information is contained in the University’s Privacy Policy.
You have a right to access your personal information that the University holds about you and to seek its correction. If you wish to access your personal information or inquire about the handling of your personal information, please contact Student Administration at student.admin@nd.edu.au