Appeal of an Academic DecisionImmunisation for Health Practitioners and Tuberculosis Management

Appeal of an Academic Decision

Immunisation for Health Practitioners and Tuberculosis Management

PERSONAL DETAILS

Full name*

Student ID*

Contact number*

Email address*

PROGRAM DETAILS

Course month intake*

Please select which month you were enrolled in.

Select or enter value

LATE SUBMISSION APPROVAL

APPROVAL FOR LATE SUBMISSION OF AN APPEAL (If applicable). Only to be completed if the appeal is logged outside of the twenty (20) working day timeframe following the initial assessment or appeal decision. If you need to submit a late appeal, please email immunisation@acn.edu.au.

LEVEL ONE (1) APPEAL

Please tick the Level 1 appeal ground(s)*

You may choose more than one appeal ground.

The existence of new relevant material of a significant nature

There was a misapplication of the procedure resulting in some real disadvantage to the student or eligible person that was the subject of the decision

The decision was manifestly wrong or excessive

There was a bias or a conflict of interest on the part of the original decision-maker(s)

Please outline your reason(s) for the Level 1 appeal*

To establish your case, please provide documentary evidence to support the ground/s of appeal selected. Please outline your reasons, there is a 4000 character limit. If you require more space for your appeal, please upload a word document and indicate this in the text box below. Please note that your appeal may be rejected if you do not provide sufficient evidence to support your case.

File Upload*

Please attach all relevant material and evidence to support your appeal. Please note, your appeal may be declined if there is insufficient evidence to support your claims.

Drag and drop files here or

File Uploaded*

Please tick which file type you have attached to support your appeal. You may choose more than one.

Medical document(s)

Assessment material(s)

Supporting documents from your manager/supervisor

Birth/marriage/death certificate(s)

Impacts from natural disaster events

Court order(s)

Statutory declaration(s)

Other

Student Declaration and Signature*

I declare that the information provided in this application is accurate and that I have read and understand the information about the appeals process presented in this form. Please type your full name as the accepted e-signature.

Send me a copy of my responses

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