Fill out the following forms within five (5) University business days from the date of the sixth (6th) absence. You may not accrue any additional absences during or after the appeal process.

  • Appeal of Withdrawal Application (online)

  • Typed letter explaining your absence/s and why you believe an appeal of withdrawal should be granted

  • Attach original documentation such as doctor's notes, obituaries, family emergency documentation, and/or a completed Steps to Success packet

Appeal Decision Notification- The program Assistant Director will e-mail you the decision of your Appeal of Withdrawal. All notifications will be sent via your TTU e-mail address. Please make sure your correct e-mail is included in the appeal and a contact phone number should questions arise.


Please fill all required fileds..
Student Name:

Dates of Absences:
CLASS/Instructor 1 2 3 4 5 6 7 8 9 10

Please explain your absences and why you believe an appeal of withdrawal should be granted:

Upload documents:

INITIALS I understand that I am ONLY allowed ONE appeal for an academic semester per course. If my appeal is approved by the Assistant Director, I know that I will NOT be allowed to file another appeal.

Absence Documentation Provided (Please Check ALL that Apply)

Doctor's Notes
Family Emergency Documentation
Completed Steps to Success
Death in the Immediate Family
No Childcare
Other (please specify)

Signature of Student

Student R#



Please enter all valid inputs..

I understand that should my documentation prove fraudulent the following will occur.

  • Immediate withdrawal from the course.

  • Appeal documents will be turned over to Student Judicial Programs which could lead to the immediate dismissal from Texas Tech University.

  • Possible suspension from Texas Tech University.
  • Appeal documents will be turned over to the TTU Police Department resulting in investigation and potential criminal charges.

I, give permission to Support Operations for Academic Retention to verify the authenticity of all documentation submitted with my Appeal of Withdrawal Application. My authorization will be in effect only until an Appeal Decision has been made.

Signature of Student



Student R#

Phone Number

Email Address