Academic Forgiveness Form

This form allows students the opportunity to request Academic Forgiveness for BSC courses. 

General Information
  • Review the Student Policy - Academic Forgiveness
  • Please allow up to 4 weeks to process
  • Confirmation with the results, will be sent to the student by the Academic Records Office
* Indicates Required Field. Note: Some fields are masked for your security.
* First name:
 
Middle Name:
* Last Name:
 
Former Last Name (s):
* Date of Birth (00/00/0000):
  
Student ID:
* Street Address:
 
* City:
 
* State:
 
* Zip:
 
* Phone (555-555-5555):
 
* Email:
 
Academic Forgiveness Information
Select all semester(s)/year(s) you would like forgiven:
* Select Semester:
 
* Year:
 
Select 2nd Semester:
Year 2:
Select 3rd Semester:
Year 3:
Select 4th Semester:
Year 4:
Select 5th Semester:
Year 5:
Select 6th Semester:
Year 6:
* Explain in detail why Academic Forgiveness should be granted:
 
* I certify to the best of my knowledge that the information on this form is true and complete without evasion or misrepresentation. I understand that if found to be otherwise, it is sufficient cause for rejections or dismissal. By checking this box you have created an electronic signature as legal as your handwritten signature.:
 
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