Pine Technical and Community College (PTCC) students are welcome to complete the Student Petition form. A student must complete this form in its entirety and submit it to an Academic and Student Affairs (ASA) staff member in Room 40B or via email at The completed Student Petition form must include all applicable supporting documentation(s). Once a request is submitted it will be reviewed by the PTCC Petition Committee and a decision will be made. Students will be notified in writing via email of the decision within 10 business days of submission unless additional documentation is requested.

In the event a petition is denied, students have the right to appeal the initial decision to the Vice President of Academic and Student Affairs—Chief Academic Office (CAO). A final appeal may be directed to the President. The President’s decision is final unless the student alleges that the decision and due process were improper, unfair, or arbitrary, in which case the student may appeal the final decision by following the policy and procedure outlined in Policy 303 Student Complaints and Grievances.

Withdrawal Request

Please read all sections below prior to submitting a backdated withdrawal request.

All PTCC current and prospective students should NOT submit a Student Petition Form until the transfer evaluation process has been completed. Students are encouraged to review the Transferring to PTCC process and Transferology, a free web-based tool, that provides fast and accurate course equivalencies while transfer evaluation is in process.

For additional support regarding PTCC Transfer Evaluation, please contact

Students may be a candidate for a backdated drop if any of the conditions are true:

  • There was a documented administrative error that affected your enrollment.
  • You have documentation of a serious illness after the withdrawal date that affected your ability to complete all of your coursework (*any applicable documentation(s) will be required as part of the petition).
  • You encountered a documented extreme and unusual circumstance which:
    • Was beyond your control.
    • Occurred after your withdrawal date.
    • Could not have been addressed during the term in which the course(s) were taken.

The following are not acceptable reasons for a backdated drop and will be denied:

  • You are not satisfied with your final grade.
  • You neglected to formally withdraw from the course(s) in question.
  • You were not aware of the deadlines.
  • You changed your major and now working towards a major or degree that does not require this course.
  • You chose to participate in non-academic activities which restricted your time for adequately managing the course expectations.
  • You wish to obtain tuition relief (a backdated withdrawal is not a mechanism to appeal tuition charges).

If any of these situations match your circumstances, you will be automatically denied for a backdated drop request.

A request for a backdated drop will be considered within the same academic year and must be supported by documentation for the request on any grounds, including compassionate care. Documentation must be official, substantive, and clearly show why you were unable to meet the deadline to withdraw from your course(s). Acceptable documentation can potentially include one or a combination of the following:

  • A letter from a PTCC Faculty or Staff (e.g. Counseling Services, BIT Team, Office of Accessibility, etc.).
  • A letter from your Doctor (not a prescription)
  • An official death certificate, published obituary, or original note from a funeral home citing your relationship to the deceased.
  • A copy of an airline or transportation ticket in your name.
  • An eviction notice.
  • A letter from any social services department.

A letter explaining your circumstances is not acceptable documentation. Failure to provide any documentation will result in an automatic denial of your request. For health (including mental health) related circumstances, written statements, and supporting documentation must outline the functional limitations that keep you from completing your course(s), not simply that you could not complete them.

Acceptable documentation includes scanned copies of original documents documents produced with MS Word/Google Docs; PDF documents, and/or clear photos (JPEG/PNG) of documents.

Student Petition Form

Read the directions carefully before submission and be sure to have the following documentation ready. PTCC students are encouraged to complete the narrative and submit all the supporting documentation at one time. A reminder that all Student Petitions must include the following:

  • A written statement outlining the reasons for the petition, including the reasons why the request is being made.
  • If applicable, clearly indicate which course(s) are linked to the Student Petition (e.g. backdated drop).
  • Supporting documentation that directly supports the reason you are claiming and following the criteria noted on the form and in the Documentation section above.

A student must complete this form in its entirety and submit it to an Academic and Student Affairs (ASA) staff member in Room 40B or via email at


PTCC Petition Committee

The PTCC Petition Committee meets regularly weekly to review Student Petitions. Members of the PTCC Petition Committee include:

  • Dean of Health Sciences and Liberal Arts
  • Dean of Student Affairs
  • Dean of Student Success
  • Business Services Representative
  • PSEO/Concurrent Enrollment Advisor
  • Student Affairs Representative
  • Customized Training Solutions Representative
  • Registrar



If you need assistance or accommodation in completing this form, please contact PTCC students may also connect with a  Student Success Advisor for assistance and book an appointment.


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