Academic Disqualification Status Appeal Form

Before completing the Academic Disqualification Status Appeal Form

• Carefully review Cal Poly’s Academic Probation and Disqualification Policy.
• Prepare the following statements:
  • Explain the extenuating circumstances you faced and how these circumstances negatively impacted your academic performance. Explain how you will develop a plan for future success that directly addresses these circumstances and includes specific actions you will take, academic strategies you plan to implement, and how you will seek out support in order to return to good academic standing.
  • Develop a Success Plan. Outline specific steps you will take to ensure future academic success. The success plan should include:
    • Review planned courses in Degree Planner, including any repeat courses needed to improve your academic standing.
    • If employed or planning to be employed, your work schedule and number of work hours per week.
    • Study strategies you plan to implement.
    • Campus resources you plan to utilize.
• Type your appeal and success plan in a separate document first, then cut and paste it into the form.
• Have all supporting documents (if applicable and available) ready in PDF format labeled EXACTLY as shown. CalPolyUsername_major_DocName.pdf
  (EX: cpmusty1_psyc_DrNote.pdf).
• Review academic probation support page to learn about resources and explanation of policy.
• Reference other resources if needed:
  • Degree Planner
  • Campus Resources