Application for an Appeal 

About this form
This form should be used if you wish to lodge a formal grievance with the Student Appeals Committee under the terms of the Student Grievance Resolution Policy. 

Students should read the Student Grievance Resolution Policy carefully, taking particular notice of the University appeal process for progress, academic and non-academic grievances which involves informal resolution, formal resolution and, if the matter remains unresolved, via the Student Appeals Committee. Please also note that all cases will be submitted for a preliminary pre-assessment of the grounds. Please refer to the policy webpage to familiarise yourself with the scope of this Committee: https://www.canberra.edu.au/alumni/home/new-graduates/student-grievances  

Student Support
Students who require assistance or advice regarding the University’s student grievance resolution processes should contact the local support services on their campus in the first instance.

If you require support and advocacy throughout the grievance process, please contact the Student Advocacy Office of the University of Canberra Student Representative Council on email: student.advocacy@canberra.edu.au

The full Student Grievance Resolution Policy is available at: https://www.canberra.edu.au/Policies/PolicyProcedure/Index/219

All communications relating to this appeal must be in writing and either emailed to SecretarySac@canberra.edu.au or addressed to:
Secretary
Student Appeals Committee
11 Kirinari St
University of Canberra
Bruce   ACT   2617

Application for an Appeal against a Decision of Faculty or Business Unit

Contact information 	
Full Name:
		
Student ID:
		
Course in which you are enrolled. 
		
Phone numbers (including mobile):		
Postal address:

		

Grounds for Appeal	

Please explain the decision or action of the University that you are appealing and the steps you have taken to resolve this issue so far.
	
Please explain why you believe the decision or action was incorrect. You should also provide any evidence you have to support your reasons (e.g medical certificates) and explain how that evidence supports your claims.

Desired Outcome	
Please provide a brief comment on what you would consider a satisfactory resolution of your grievance.

	

I declare that I have read the Student Grievance Resolution Policy and that the information given on this form, and on any accompanying papers, is a true and complete statement of facts.

I acknowledge that delay or failure to reply to correspondence from the Student Appeals Committee may delay resolution of my appeal beyond the timeframes prescribed in the Student Grievance Resolution Policy.

Privacy – Personal Information

You are entitled to protection of the personal information you provide to the University of Canberra (UC) under the Information Privacy Act 2014.  This means that any personal information we collect about you is treated according to the law and applicable policy. See UC’s Privacy Policy (available at www.canberra.edu.au/privacy) for more information.

The personal information collected on this form will allow your appeal to be considered by the Student Appeals Committee under the University’s Student Grievance Resolution Policy. In considering your appeal, the University may disclose some personal information we hold to other relevant organisations, including overseas organisations or regulators. For example, if your studies involve an organisation related to the University, such as the University of Canberra College, a third party provider or an external research or teaching centre, your personal information may be disclosed to that entity. 

By signing and submitting this form, you consent to the University of Canberra using and disclosing your personal information as described above.

Signed   ……………………………………………..

Date   …………………………………..