Adjustments and Appeals Committee Web Form

Academic Adjustments and Appeals Petition

Submission form for petitions to the Academic Adjustments and Appeals Committee
  • Please list your myUCA PIN # if known. If you do not have your myUCA PIN you will need to upload a copy of your written signature below. Mouse-signatures will not be accepted. These items are used to verify your identity and protect the privacy of your academic records.
  • If unsure of the exact graduation date please select the first day of the approrpiate month. May for Spring, August for Summer and December for Fall.
  • Please type a brief explination detailing your request. If you would like to attach additional documentation you may do so below.
  • Please upload additional supporting documents, for example transcripts or medical records. If you were not able to provide your myUCA PIN above then please be sure to upload your scanned signature as well.