Academic Amnesty Application Form

Student Name
Student ID #
Telephone #
Email
Address
Street Address City State ZIP Code
I meet all of the following eligibility requirements for Academic Amnesty:
I would like to exercise my option for Academic Amnesty and I understand that the following guidelines will be applied to my academic record
I also understand that Academic Amnesty cannot be considered in determining Satisfactory Academic Progress for financial aid eligibility. The Financial Aid Office will continue to review all the grades on my transcript.
Student Signature
Date
MM slash DD slash YYYY

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