Student Remediation and Records Review

☐ Other: _________________________________________________

Effective Date of Decision: _________________________________

Final Decision Rationale:

SECTION IX. STUDENT EVALUATION AND PROGRESS COMMITTEE REVIEW Complete when committee review is required.

Committee Review Date: ____________________________________

Committee Determination:

Committee Chair/Designee Name:

Signature: _______________________________________________

Date: ___________________________________________________

Supporting Documentation Attached or Linked:

☐ Committee Meeting Minutes/Decision ☐ Student Performance Data ☐ Remediation Plan ☐ Reassessment Results ☐ Student Communication ☐ Other: _________________________________________________

SECTION X. STUDENT FINAL ACKNOWLEDGMENT The student acknowledges that the remediation process and final outcome have been communicated.