Student Appeal Application

To lodge an appeal, please fill in the Student Appeal Application form. Read all questions carefully to make sure you provide the required details.

Before submitting this form:

You should familiarise yourself with the stages and deadlines in the��Student Complaint Resolution Policy.
You may wish to contact��for independent and confidential support and advice.

Helpful links

Please be prepared to fill out this form in one sitting so you do not lose your entered data.

Lodge your appeal

Your details

Full name

ID number

Student email address

Other email

Phone

Faculty

School

Program

Course (if applicable)

Stages of your complaint

From which staff member(s) or Committee have you already sought a resolution about this complaint?

Re-order	Name	Role	Weight	Operations
	Name	Role	Item weight

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Stage 1 (initial complaint)

Describe your initial complaint and steps taken to seek to resolve the complaint at Stage 1

Type of complaint/decision

If other, please specify

Stage 2 (formal review)

Name of decision maker

Position of decision maker

Date of decision

Provide a brief summary of the Stage 2 complaint and the outcome, including any resolution offered.

Student care

Have you contacted an EWO at for independent and confidential support and advice? If not, you may wish to consider doing so.

Chronological summary of events

Set out the key events, dates and communications concerning the decision or outcome you wish to appeal.��

Include the document reference number (e.g.: Doc 1) for each supporting document that you will upload to support your appeal application.

Note: supporting documentation can be uploaded at the end of this form.��

Provide details below

Re-order	Date/period	Event	Document ref no.	Weight	Operations
	Date/period	Event	Document ref no.	Item weight

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Grounds for appeal

Please detail your grounds of appeal.

*This is the basis for your appeal, e.g. why was the decision incorrect; if you are relying on non-compliance with a policy or procedure, what part was not complied with?

Note: if there is insufficient space, you can upload a statement of grounds for appeal under section 6.

What are your grounds of appeal?

What outcome are you are seeking or proposing?

Documentation & evidence

If there is any documentation or additional evidence you would like to have considered with your appeal, please upload here.��

Upload all documents (including those referred to in Chronological Summary of Events and Grounds for Appeal sections) that you wish to be considered in assessing your appeal.��

Include a copy of the Stage 1 Initial Complaint, the Stage 2 Formal Review decision, and any other supporting documentation that is relevant to your appeal.

File upload

Re-order	Add documentation or additional evidence	Weight	Operations
	Add documentation or additional evidence One file only. 20 MB limit. Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pdf, doc, docx, ppt, pptx, xls, xlsx, html, zip.	Item weight

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Declaration

I declare that the information provided and in the attached documents is complete, true and correct to the best of my knowledge.

Feedback

If you have any feedback on the Student Complaint Resolution process, please complete our feedback form.

If you have any queries about this form or the student appeals/complaint resolution process, please contact Student Affairs at: complaint.resolution@adelaide.edu.au.

Enquiries

Any enquiries regarding the Student Complaint Resolution Policy can be directed to the Student Grievance and Conduct Advisors in Student Affairs.

Contact Student Affairs

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