Print this page out, fill out the form, attach it to the assignment or exam in question and turn it in to the instructor. Requests for reappraisals will not be accepted on the same day that material is returned.

If this is a request for reappraisal of a group assignment, please indicate the group number and include the name of each student in the group.

Family Name :

First Name :

Student ID :

Contact Email :

Instructor :

Section :

Date of Submission :

Date Returned :

Description of what you would like to have reappraised and why:

NOTE: Justification for your claims must be provided or the work will not be reappraised.

I understand that the entire body of work will be remarked and that the reappraisal could result in the mark being adjusted higher, lower or not at all.

Student Signature :