Bismarck State College
Academic Record Drop/Withdrawal Appeal Form
Bismarck State College, P.O. Box 5587, 1500 Edwards Avenue, Bismarck, ND 58506    701-224-5420 :: 800-445-5073
The form allows students the opportunity to appeal a transcript grade following a course drop, a withdrawal to zero credits, or past the last day to drop with record due to extenuating circumstances (medical, military, death in immediate family, natural disasters, etc).

Reason for Denial of an Appeal
If the appeal is not received within the allotted time frame as outlined in the Academic Records Drop/Withdrawal Appeal Policy.
Failure to follow proper drop/withdrawal procedures as outlined on the BSC website at: www.bismarckstate.edu/current/records/withdraw
Lack of knowledge of applicable dates and deadlines.
Changes in job, work schedule or employment (*unless related to a natural disaster with sufficient documentation).
Failure to verify class schedule and/or schedule changes.
Non-attendance of class(es).
Personal errors in judgment regarding:
Availability of finances to pay associated charges
Class work load and academic ability
Time management
Availability of transportation to and from class
Dissatisfaction with course content or method of instruction. If appealing is for this reason, please contact the Dean of Academic Affairs.
Inadequate, late application or loss of eligibility of financial aid, scholarships, or third party authorization.
Non-receipt of information/notices sent to student's email and/or USPS address.
Not benefiting from:
a fee (e.g. wishing to appeal the mandatory/student/class/course/program fees)
course credits in regard to degree requirements or changes in major
Lack of proper, descriptive documentation.

Academic Records Drop/Withdrawal Appeal Policy can be found at: www.bismarckstate.edu/uploads/resources/373/CourseDropWithdrawal.pdf

Guidelines:
Type your information into each field, check the signature box and click submit at the bottom of this form.
Documentation must be submitted to the Academic Records Office upon completion of the form.
Academic Records Office - Schafer Hall
Fax Number - 701.224.5643
Mailing Address - BSC, Academic Records, PO BOX 5587, Bismarck ND 58506
Email - bsc.records@bismarckstate.edu (must come from your BSC e-mail account)
This process may take up to 7 working days.
After the Academic Records Office reviews the form a postal mail letter will be sent to notify you if the form is approved or denied.

Note: Remember the burden of proof is on you. The more clear, complete, and specific you can be, the less chance of misunderstanding and the better the Academic Records Office can perform their task.
* Required Fields
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W
Note: Student EmplID # can be found on your Mystic Card, located on the back right hand corner (first 7 digits) or you can look it up online Click Here

* Street Address:
* City:
* State:
* Zip Code:
* Day Phone:
* Email Address:
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* * Do you receive GI Bill benefits? Yes No
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* * Drop/Withdrawal Term:
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*List ALL courses that you wish to Appeal:
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Subject  
Ex. ENGL  
Catalog #
110  
Class #  
10258  
                 Class Title
              College Composition I
Action Requesting      
See definitions below      
Last Date  
of Attendance
  
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*View your class schedule in CampusConnection to ensure all information is completed.
Help Sheets to view your class schedule can be found at http://www.bismarckstate.edu/connection/.
NOTE: Appeal will not be processed if courses are not listed above

Action Requesting Definitions
Appeal Action Requesting Description
Grade to W Removal of current letter grade and change to Withdrawal with (W) record on transcript
Grade to No W Removal of current letter grade and change to Withdrawal without record on transcript
W to No W Removal of current Withdrawal with (W) record on transcript and change to Withdrawal without record on transcript



* Appeal Reason:
Appeal Reason Suggested Documentation
Medical Letter from the Medical Physician or licensed professional on official letterhead including specific dates of treatment and condition warranting appeal
Military Orders listing dates of activation
Death in Immediate Family Funeral Service Bulletin showing relationship to deceased (Immediate Family members include: husband, wife, son, daughter, father, mother, stepparents, brother, sister, grandparents, grandchildren, stepchildren, foster parents, foster children, brother-in-law, sister-in-law, son-in-law, daughter-in-law, mother-in-law, and father-in-law)
Natural Disaster Official newspaper article from area in residence
Natural Disaster (work related) Letter on official letterhead from employers human resource department.
Other Used only for students who attempt to drop all classes in CampusConnection and receive the following error "Unable to drop class, will drop below required minimum units for enrollment."


Please note - The Appeal Drop/Withdrawal application for the current term that is denied will be processed as a regular withdrawal. All dates and deadlines for regular withdrawal will be followed.

* I accept all academic and financial consequences resulting from this appeal. Check this box:
* I certify to the best of my knowledge that the information on this form is true and complete without evasion or misrepresentation. I understand that if found to be otherwise, it is sufficient cause for rejections or dismissal. By checking this box you have created an electronic signature as legal as your handwritten signature.