Special Appeals Application

Please download and complete the form, attach supporting documentation and submit the completed application form by email to the Associate University Secretary (Senate), Tara Harrington, at specialappeals@trentu.ca.

The Trent University Special Appeals Committee is an impartial adjudicative appeal body of last resort for students on academic matters. Its role is to judge whether the application of University regulations, policies or practices has worked undue hardship on any student who appeals.

Authority for collection, use and disclosure

The collection, use and disclosure of personal information with regard to special appeals is authorized under The Trent University Act, 1962-63 Section 12, and under the terms of reference of the Special Appeals Committee approved by the University Senate and the procedures adopted by the Special Appeals Committee. This information is required to document your case for the Special Appeals Committee, to establish a hearing, and to communicate with you regarding your appeal. If you have any questions about the collection, use or disclosure of this information by the University, please contact the Secretary of Senate at the above address.

Please provide your current contact information (Note: You must provide updated contact information if there is a change).

Name:

Student Number:

College:

Campus: Peterborough Durham

Local Address:

Permanent Address:

Primary Telephone Number:

Secondary Telephone Number:

Trent Email:

For security reasons, only Trent email addresses will be used.

Details of Appeal:

1.	State the specific University regulation, or the Department/Committee ruling or decision, that you are appealing (provide copy).

2.	Indicate what steps you have taken in this matter, and when you took them.

Appealed to the instructor

Date of Appeal to Instructor:

Appealed to the Department/Program Chair

Date of Appeal to Department/Program Chair:

Consulted Academic Advisor

Date of Consult with Academic Advisor:

Petitioned Committee on Undergraduate Petitions

Date of Petition to Committee on Undergraduate Petitions:

Other [please specify].

Please confirm that you have exhausted all lower levels of appeal. Yes

3.	Briefly describe the history of the matter under appeal, along with the decisions rendered and by whom. Attach documentation from previous appeal, or decision.

4.	State the grounds for your appeal. Attach supporting documentation.

5.	State the remedy or relief you are requesting. Do not leave this blank. You may provide alternatives.

Hearing:

1.	You may request a personal hearing before the Special Appeals Committee to present your case. If you request a hearing, the respondent also has the right to be present to make a submission. If you do not request a hearing, this written application and attached documentation will form the basis of your appeal.

I hereby request a hearing before a panel of the Special Appeals Committee:

Yes No

2.	If you elect to have a hearing and wish to have a person present for support, please provide his/her name.

Name of Support Person:

3.	If you choose to be represented by another person or by counsel at the hearing, please provide his/her information.

Name of Representative:

Contact Information of Representative:

4.	If you intend to call witnesses at the hearing, please provide their names below and indicate briefly what evidence they will provide. [The respondent also has the right to call witnesses]

Name of Witness #1:

Evidence from Witness #1:

Name of Witness #2:

Evidence from Witness #2:

Note: The appellant is responsible for ensuring the availability of their support person or witnesses (if any) for the hearing at the scheduled time and for informing them of the time, date and location of the hearing.

Documentation:

Provision of documentation is the sole responsibility of the parties to the appeal, with the exception of the appellant's Trent academic record, which may be obtained by the Secretary.

The following documents should be included, if applicable:

a copy of the regulation of ruling appealed from.

a copy of the course syllabus (mandatory for grade appeals).

a copy of your previous petition/appeal, including supporting documents.

a copy of the decision in your previous petition.

a copy of any evidence supporting the stated grounds of the appeal; e.g., medical documentation.

Each member of the Special Appeals hearing panel and the parties to the appeal will be provided, prior to the hearing, with copies of all documentation submitted by the parties, together with a copy of the appellant's academic record. In order to ensure full and fair consideration of the appeal, it is incumbent upon both parties to provide all documentation relevant to the appeal.

Attachments

I have attached the following documents to this application:

Previous decision (required)

Certification

In submitting this appeal, I understand that the Special Appeals Committee, through the Secretary, may obtain a copy of my academic record from the Registrar’s Office and, for the purpose of academic integrity cases, my record of attempts at the online academic integrity module from the Academic Skills Office.

I understand that this application and the documentation I submit in support of it will be provided to the respondent and to the members of the Special Appeals hearing panel making a decision in my case. I certify that the information given in this application is true and complete to the best of my knowledge.

Date:

Signature:

The Secretary will retain the original and provide copies to the appellant, respondent and the members of the Special Appeals hearing panel