ࡱ> jizi ,bjbjzz 7^jjj j 8I\V;Q:::::::4=?X::H; ^: : -46Yyj4:&;0V;5B@~B@466B@6< ::a @V;B@j Y : CONFIDENTIAL FORM CSAC Queens University Belfast Central Student Appeals Committee Appeal Form This form is for use by undergraduate and postgraduate taught students and should only be used if you are appealing a decision made by the Faculty Student Appeals Committee to the Central Student Appeals Committee (CSAC) (Stage 2). If you decide to request an appeal to the CSAC under the Universitys Academic Appeals Regulations (Taught Programmes), this form should be completed within five working days of the outcome of the appeal to FSAC and should state the ground on which you are appealing. Please send the form to Academic Affairs, Level 6, Administration Building, Queens University Belfast, BT7 1NN or by email to  HYPERLINK "mailto:appeals@qub.ac.uk" appeals@qub.ac.uk. Please read our HYPERLINK "http://www.qub.ac.uk/directorates/AcademicStudentAffairs/AcademicAffairs/AppealsComplaintsandMisconduct/AcademicAppeals/"Academic Appeals Regulations (Taught Programmes) which outline the procedure for appeals to CSAC. You are advised to contact HYPERLINK "http://www.qubsu.org/AdviceSU/"SU Advice for advice and information on the Academic Appeals Regulations. You must also attach documents in support of your appeal and list them on the final page of this form. All sections of this form must be completed. It is your responsibility to ensure that all the supporting evidence which you wish the CSAC to consider is attached to this form. Academic Affairs will acknowledge receipt of the appeal. You will be required to attend a meeting of the CSAC to present your case based on your ground(s) of appeal. Full Name: Student Number: School: Programme of Study: Year of Study (i.e., Year 1, 2,etc) Address for Correspondence: Tel no:Mobile no: E-mail: Please read our HYPERLINK "/directorates/AcademicStudentAffairs/AcademicAffairs/AppealsComplaintsandMisconduct/AcademicAppeals/TaughtProgrammes/GuidanceforStudents/FSAC/"CSAC - Student Guide Advice and guidance on this procedure is available from HYPERLINK "http://www.qubsu.org/AdviceSU/"SU Advice Please state the decision against which you are appealing (e.g. requirement to withdraw, decision to cap a re-sit a module, degree classification) and the date this decision was communicated to you. You should attach a copy of the letter from the Board of Examiners setting out the decision you wish to challenge. Grounds of AppealPlease consider carefully the ground(s) on which you wish to lodge an appeal and indicate as appropriate. An appeal will NOT be considered unless it is made on one of the permissible grounds as follows: New evidence has become available which could not have been provided to the FSAC (evidence withheld from the FSAC will not normally constitute new evidence). There has been a procedural irregularity in the FSAC procedure which has had a demonstrable impact on the outcome. Please give full details of the circumstances relevant to the ground(s) of the appeal. Please continue on a separate sheet if required. Please state the outcome you are seeking from the appeal, noting that the CSAC cannot change marks or allow you to re-sit or retake a module which you have already passed. You should consult the Universitys Regulations and your Schools Programme Regulations to check that the outcome you are seeking is permissible under the Regulations and, therefore, an option available to the CSAC. Please list the documentation attached in support of your appeal. Please note that documentation submitted after the deadline for student appeals to the CSAC (5 working days from the outcome of the appeal to FSAC) may not be considered by the CSAC. Please note: all hard copies of supporting documentation submitted will be destroyed within 30 days of the appeal hearing, unless requested to be returned. You will be required to attend in person to present your appeal to the CSAC. If you fail to confirm whether or not you wish to attend by the time specified by Academic Affairs you will be deemed to have withdrawn your appeal and it will not be considered. The information on this form and any supporting evidence submitted by you will be used to consider the appeal and will, therefore, be disclosed to the School and the CSAC. In signing this appeal form you are declaring that you have read and understood the relevant University Study Regulations and the Academic Appeals Regulations (Taught Programmes) and that you consent to this information and supporting evidence being disclosed to the School and the CSAC as necessary for consideration of your appeal. If you wish to withdraw consent to any information or supporting evidence being disclosed to your School or the CSAC, you may do so at any time by sending an email to  HYPERLINK "mailto:appeals@qub.ac.uk" appeals@qub.ac.uk, providing the information has not already been disclosed. By signing this appeal form, you are also confirming that your appeal is a true reflection of your situation. Signed: Date: This appeal must be signed and dated and returned to Academic Affairs, Level 6, Administration Building, Queens University Belfast, BT7 1NN or emailed to  HYPERLINK "mailto:academic-affairs@qub.ac.uk" appeals @qub.ac.uk     :;BS]cijtS T U x ) ` b ɽߦzzzzzozcWccWWzhJ8hOU5CJaJhJ8hs5CJaJhJ8h. 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