IPL Notice of Appeal (Final Course Results)

Students submitting this application should ensure they have read and understood CPLED’s policies.

This form should be used to provide CPLED with notice of your intention to appeal an IPL result that is subject to appeal under the IPL Course Policy.  You will complete a different form with the specific facts and evidence underlying your grounds for appeal after CPLED provides limited disclosure of your IPL final assessment materials. Your review of the IPL Disclosure will be monitored by a proctor using the same set-up as the one required when you wrote your IPL final assessment.

In the Matter of the Student:*

First Last

CPLED Student ID Number*

Find your ID Number in the Student Portal under “MENU.”

Address of Student*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone Number of Student*

Email Address of Student*

In the Matter of a Decision of:*

Insert CPLED staff name

Dated:*

Insert date of CPLED staff decision

Which decision is the subject of this Notice of Appeal?*

IPL final course results

An assessment result based on the grounds of failure to accommodate

Confirmation for Release of IPL Disclosure*

As part of the appeal process, CPLED provides limited disclosure of IPL final assessment materials (the “IPL Disclosure”). Your review of the IPL Disclosure will be monitored by a proctor using the same set-up as the one required when you wrote your IPL final assessment. CPLED provides the IPL Disclosure in accordance with the terms below. You must complete each check box before you can sign and submit the form.

The entirety of the IPL Disclosure is Confidential Information or Proprietary Content as defined by CPLED policy and are provided to you for the sole purpose of the CPLED appeal process.

You remain bound by the Student Agreement in which you agreed you were bound by all CPLED and IPL policies and you agreed to comply with these policies.

The IPL Disclosure is being provided to you for the sole purpose of pursuing the CPLED appeal process.

You will hold the IPL Disclosure in confidence and will not copy, in whole or in part, publicize, or disclose the IPL Disclosure to others, except for professional consultants, such as legal counsel, who require the IPL Disclosure in order to carry out the purpose it has been provided to you and who are subject to binding obligations of confidentiality and restricted use at least as protective as those outlined in this correspondence.

You will destroy any hard or electronic versions of the IPL Disclosure within 24 hours of that the purpose for which these materials are being provided has been met or completed.

CPLED retains all right, title and interest in and to the IPL Disclosure, including, but not limited to copyright. By CPLED providing you the IPL Disclosure on the basis outlined in this document, you are not being given, directly or indirectly, any right or licence to any Confidential Information or Proprietary Content to the IPL Disclosure or any other CPLED material. You are also not acquiring any intellectual property or other rights owned by or licensed to CPLED.

Any breach of the provisions of the Confirmation for Release of IPL Disclosure will result in irreparable harm to CPLED. CPLED reserves the right to avail itself of all available legal remedies, including but not limited to obtaining an interim, interlocutory and permanent injunction and other equitable remedies, in addition to seeking monetary damages and reimbursement of legal costs.

Signature*

First & Last Name

I confirm that I have read and understood the requirements of this form and any relevant CPLED policies. I affirm that all the information and documentation provided in support of this application are accurate and true. I understand that CPLED may request further information and documentation from me in support of my application. For the purposes of verifying authenticity, I authorize CPLED to contact anyone who provided documentation submitted in support of this application, including but not limited to medical documentation.