Teacher Education Program Candidate Appeals Form

(For best results, please fill out this form using the Google Chrome Browser.)

This form will email directly to Dr. Christie Riley, director of teacher education and assistant professor of education. Her contact information is (580) 327-8694 or clriley@nwosu.edu.

Today's Date *

Candidate's First Name *

Candidate's Last Name *

Student ID Number *

Adviser's First Name *

Adviser's Last Name *

Candidate's Major *

Statement of Request *

Compile into one document the following: a current transcript; current degree audit (from Registry Office); individual plan for program completion; copies of test scores or registration for the OGET, OSAT, OPTE; and other pertinent information.

File contains in one document all of the items requested for appeal. *

Information Below is for Teacher Education Program Use:

This space is provided for these individuals to make written comments on the appeal, approve or deny, provide their signature and the date.

Rationale/Comments from Director of Teacher Education:

Approve or Deny Signature______________________________________________________Date_________________

Rationale/Comments from Associate Dean of Education:

Approve or Deny Signature______________________________________________________Date_________________

Rationale/Comments from Vice President for Academic Affairs:

Approve or Deny Signature______________________________________________________Date_________________