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This form is to be completed by a student who has already completed the informal process to
resolve his/her concern informally, who still believes that he/she has received an unfair mark/exam decision from BITSPEC and who wishes to appeal that decision.
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Student Name(*)
Please enter student name
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Student Phone Number(s):(*)
Please enter a valid Phone number
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Student e-mail address:(*)
Please enter a valid email address
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Program Name: (*)
Please insert the program name
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Course Code:(*)
Please enter the course Code
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Instructor member: (*)
Please enter the instructor member name
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Date the discussion took place with the Instructor:(*)
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Type of Appeal: (*)
Please flag one of the checkboxes
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Date of submission(*)
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