College of Science

Assistant Dean for Undergraduate Studies Office

Grade Appeal Form

Note: Grades can only be appealed within the appeal duration specified by the Deanship of Admission and
Registration after the official announcement of grades. Please note that the appealed grade might change to lower
or higher or remain unchanged. Please make sure to make payment of the grade appeal fees (OMR 5) and attach
the evidence or the payment notification with this form.

Section 1: To be filled by the student.

Student name:       ID.       College: Select ONE

Student’s email:       Student’s cellphone:      

Course code:       Course instructor:      

Department: Select ONE Course section:       Semester:      

Received feedback and/or the marks for the in-semester assessments? Yes. No.

Requested the course instructor to recheck your grade? Yes. No.

If Yes, what was the response? There is a grade change. There is no grade change.

Grade given: Select ONE Grade expected: Select ONE

Reasons for the appeal.

1.      

2.      

3.      

4.      

Student’s signature:       Date:      

Note: Please attach supporting documents, if necessary. Save the form as follows: your SQU ID_Dept_Appeal form
(15737_BIOL_Appeal form) and e-mail it to the ADUGS office.
Section 2: To be completed by the ADUGS office.

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 Forward the appeal form to the concerned department? Yes. No.

If No, state the reason.      

ADUGS signature:       Date:      

Section 3: To be completed by the Departmental Appeal Committee.

The members (Note: at least 3 faculty members including a chairperson ):
Chairperson:       Signature:      

Member 1:       Signature:      

Member 2:       Signature:      

Member 3:       Signature:      

The Committee feedback.

1.      

2.      

3.      

4.      

The decision: There is a grade change. There is no grade change.

If there is a grade change, please attach the grade change form, signed by the instructor and HoD, with this
form.
Chairperson’s signature:       Date:      

Note: The chairperson should save the form with same name as PDF and e-mail it to the ADUGS office.

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