Student Petition Request Form

Your submission of this form indicates you understand the rules and guidelines of the petition process and gives Walden staff permission to contact anyone mentioned in your petition for additional information. If you have any questions, please contact an academic advisor.

Name:  
Student ID or SSNO:  
Email Address:    
Program:  
Faculty Mentor (If applicable):
Have you contacted an Academic Advisor prior to making this request?:
*Note: You are not limited to the size of the boxes below. This box information will scroll as necessary.
Which university policy are you petitioning?
 
What is the outcome you are seeking?
 
Describe why an exception should be made. Please be as specific as possible and include all relevant information. It is the student's responsibility to submit all relevant documentation.
 
Retain copies of all information submitted. The documents you submit will remain on permanent file with the university. Petition decisions will be made based on a case-by- case basis and the relevance and reliability of provided documentation. Petitions will be processed within 10 -15 working days of receipt. Students will be notified of the decision via U.S. mail. Please contact an academic advisor at 1-800-925-3368 if you have any questions.