ACADEMIC APPEAL FORM Stage One (Formal Stage) Taught Programmes You should complete this form if you want to formally raise concerns about an academic result or circumstances relating to it. We will take your concerns seriously and our procedure is designed to enable the circumstances to be considered fully. THIS DOCUMENT CONTAINS GUIDANCE FOR COMPLETING THE FORM AND SHOULD NOT BE SUBMITTED If you choose to submit a Stage One Appeal (Formal Stage), you are strongly advised to seek advice from the Student Union Advice Centre () before submitting this form YOUR PERSONAL DETAILS Please enter these details from your campus card Ms, Miss, Mrs, Mr, Dr, Title First name Please enter these details from your campus card Last name Please enter these details from your campus card Registration Number This is the School you are currently registered to e.g. School of Study LDC or CMP This is shown on your student home page in Evision Name of Course Please enter these details from your campus card UG or PGT Name of Academic This is shown on your student home page in Evision Adviser Address You should provide an address for written (please enter the postal address correspondence that will be current for at least the next you wish us to use to communicate with you about 6 weeks. your appeal.) Post Code Our main communication with you will be via your UEA UEA Email address email address Personal Email address Essential if you have been withdrawn from or have (if you wish us to send also completed your course communication about your appeal to a personal address). Are you a Tier 4 Visa student? Yes No
ACADEMIC APPEAL FORM Stage One (Formal Stage) Taught Programmes You should complete this form if you want to formally raise concerns about an academic result or circumstances relating to it. We will take your concerns seriously and our procedure is designed to enable the circumstances to be considered fully. THIS DOCUMENT CONTAINS GUIDANCE FOR COMPLETING THE FORM AND SHOULD NOT BE SUBMITTED If you choose to submit a Stage One Appeal (Formal Stage), you are strongly advised to seek advice from the Student Union Advice Centre () before submitting this form YOUR PERSONAL DETAILS Please enter these details from your campus card Title Ms, Miss, Mrs, Mr, Dr, First name Last name Please enter these details from your campus card Registration Number Please enter these details from your campus card School of Study This is the School you are currently registered to e.g. LDC or CMP Name of Course This is shown on your student home page in Evision UG or PGT Please enter these details from your campus card Name of Academic Adviser This is shown on your student home page in Evision Address (please enter the postal address you wish us to use to communicate with you about your appeal.) You should provide an address for written correspondence that will be current for at least the next 6 weeks. Post Code UEA Email address Our main communication with you will be via your UEA email address Personal Email address (if you wish us to also send communication about your appeal to a personal address). Essential if you have been withdrawn from or have completed your course Are you a Tier 4 Visa student? Yes No
Guidance-for-LTS-Appeal-Form-Stage-1-v2.3.docx