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.

Declaration
By lodging this appeal I, * confirm that I have read and understood the relevant sections of University regulations, policies or procedures relating to my Appeal Type. I 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 that I have reviewed the Policy: Student Appeals prior to submitting this appeal and acknowledge the Grounds of Appeal for this appeal type.
Student details
Student Identification Number *
First name *
Surname *
Date of birth *
Domestic / International *	Domestic International
Phone / Mobile *
Program code *	(Please enter the code and name of the program you are enrolled in, in this section, not the code and name of the course/s you are appealing – you should refer to the relevant course with its correct code 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 for assistance before submitting your form. Please remember you can only appeal a decision which has officially been made against you. For example, you cannot appeal under ‘Special Consideration’ if you have not yet had an application for Special Consideration denied, or you cannot appeal under the Final Mark of a Course if the Final Mark has not been officially published.
Reason of my appeal *

Uploads and Checklist
Written statement *
Supporting documentation	add more
Upload a max of 5 files (max 30MB total). Supported file types for upload .docx, .pdf, .jpeg, jpg, jpeg, png. Please note .dng files are not accepted. If you need to upload more than 30MB, consider emailing attachments separately student.appeals@nd.edu.au. Any attachments must be submitted at the same time as the form. 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.
Upload declaration *	I have attached a Written Statement explaining where I believe I meet the Grounds for Appeal for my appeal type. I have attached a copy of correspondence from the University notifying myself of the decision that I am appealing (and which is appealable under the Policy: Student Appeals) I have attached other relevant evidence (if any) (eg, medical)

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