PREP Appeal Request

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

This form should be used to file for appeal of a reconsideration decision that was issued by CPLED’s CEO or designate under the PREP Reconsideration and Appeal Policy.

In the Matter of the Appellant:*
Insert name
CPLED Student ID Number*
Find your ID Number in the Student Portal under “MENU”.
Address of Appellant*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone Number of Appellant*
Email Address of Appellant*
In the Matter of a Decision of:*
Insert Chief Executive Officer (CEO) or designate name
Dated:*
Insert date of CEO or designate decision
MM slash DD slash YYYY
Grounds for Appeal*
Set out the basis for your appeal. If additional space is required, attach extra pages. With reference to the Appeal Record that was provided to you by CPLED, explain why you believe the reconsideration decision is unreasonable or why you believe you were negatively impacted by a lack of procedural fairness. Appeals are limited only to the information and documentation in the Appeal Record, unless the Appeal Panel is satisfied that it is in the interests of justice to consider factual information or documentation that was not before the CEO at the time of reconsideration, after considering all of the factors outlined in the PREP Reconsideration and Appeal Policy.
Grounds for Appeal extra pages
(if applicable)
Max. file size: 200 MB.
Are you filing supporting materials?*
- Yes
- No
What result are you seeking from the Appeal Panel?*
Did you submit payment of the appeal fee?*
If yes, attach a copy of your proof of payment.
- Yes
- No
Proof of Payment*
Max. file size: 150 MB.
Counsel for Appellant
(if applicable)
Address of Counsel for Appellant
(if applicable)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone Number of Counsel for Appellant
(if applicable)
Email Address of Counsel for Appellant
(if applicable)
Signature*
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.
First & Last Name