Appeal request

Student information

First name: *

Middle name:

Last name: *

Please write your name above as it appears on your student card.

uOttawa email address: *

Phone: *

Faculty or school: *

Program of study: *

Request

Type of request: *

Appeal of mandatory withdrawal from the program or faculty

Course enrolment after deadline

Retroactive withdrawal with financial credit

Retroactive withdrawal without financial credit

Briefly explain the reason for your request (255 characters maximum): *

For withdrawal or enrollment requests, please specify the course(s) and term(s):

For the mandatory withdrawal appeal request, please indicate the term and year:

Withdrawal term:

Year:

Supporting Documents

Letter of appeal (max file size: 2 Mb): *

Accepted formats: jpg, jpeg, png, doc, docx, pdf.Choose fileChosen file:

Medical certificate and/or other supporting documents (max file size: 2 Mb): *

Accepted format: jpg, jpeg, png, doc, docx, pdf.Choose fileChosen file:

Additional supporting documents (max file size: 2 Mb):

Accepted formats: jpg, jpeg, png, doc, docx, pdf.Choose fileChosen file:

Additional supporting documents (max file size: 2 Mb):

Accepted formats: jpg, jpeg, png, doc, docx, pdf.Choose fileChosen file:

Terms and Conditions

By submitting an request you understand, acknowledge, and agree to the following:

I understand that if my request is approved, there could be impacts on the scholarships and/or financial aid granted to me. I accept the responsibility to consult the Financial Aid and Scholarships Department to find out about these impacts before submitting my application.

I understand that if my request is approved, there may be impacts to my course sequence for the co-op program and my eligibility to continue in this program. I accept the responsibility to consult the Cooperative Education Programs office for these impacts before submitting my application.

By clicking submit, I confirm that the information I have provided in this form is complete and accurate.

I am aware and I confirm: *

Yes

Please leave this field blank:

Notice of Collection of Personal Information
Your personal information is collected under the authority of the University of Ottawa Act, 1965, in accordance with the Freedom of Information and Protection of Privacy Act of Ontario and University Policy 90. The personal information you provide on this form will be used by the University for purposes consistent with the administration of University programs and activities, and the provision of services and performance of functions including recruitment, admission, enrolment, academic programs, evaluations, official document requests, financial aid and awards, assisting student associations and graduation. If you have questions about the collection, use and disclosure of your personal information, please contact InfoService at infoservice@uOttawa.ca.