Academic Bankruptcy Form

Petition for GPA Adjustment

First Name(Required)

Applicant’s first name.

Last Name(Required)

Student #(Required)

Email Address(Required)

Phone Number(Required)

Term/Year1

Provide Term and Year for time frame desiring academic bankruptcy.

Term/Year2

Provide Term and Year for time frame desiring academic bankruptcy.

Term/Year3

Provide Term and Year for time frame desiring academic bankruptcy.

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