LA&PS Pending Grade Request (PDG) Form

Please fill out this form when requesting that an enrolment block (PDG) be mounted or removed from a student’s record as the result of their involvement in an academic misconduct investigation or decision.

If you have any questions or issues with this form, please reach out to lapshonesty@yorku.ca. A copy of the completed form will be sent to you, the Registrar’s Office, and the LA&PS Academic Honesty team.

Person Requesting PDG
Name of Person Submitting Form: Name of Person Submitting Form: First Last
Email:
Telephone Extension:
Maximum of 5 digits allowed. Currently Entered: 0 digits.
Position:
Program:
Course Information
Course Number & Section:
Please copy and paste the information as it appears in PES:
Example AP HIST 3140 Cr=3.00 A [F13-W14 F AP]
Name of Course Director: Name of Course Director: First Last
PDG Request
Case Status:
Student Information
Please list student information for a PDG to be mounted because of an alleged case of academic misconduct.
Student Full Name
Student Number
Maximum of 9 digits allowed. Currently Entered: 0 digits.
Student Information & Sanction
Details requested below about a Permanent Grade of Record (PGR) or Transcript Notation are listed in the student’s Decision Letter that was copied to the unit. If the Decision Letter does not specify a PGR or Transcript Notation, please indicate "no".
When sharing the student's Final Grade please apply any required sanctions.
If the student was assigned a sanction that includes completion of an academic honesty workshop, please do not request removal of the PDG until the LA&PS Academic Honesty team confirms that the student has completed this requirement.

If you have any questions or issues with this form, please reach out to lapshonesty@yorku.ca.
Student Full Name
Student Number
Maximum of 9 digits allowed. Currently Entered: 0 digits.
Student Final Grade (after sanction applied)
Student Permanent Grade of Record (PGR)

Student Permanent Grade of Record (PGR) Yes No
Student Transcript Notation

Student Transcript Notation Yes No
If yes, duration of transcript notation
Effective Date If yes, duration of transcript notation
Effective Date / MM / DD YYYY
Expires Date
Expires Date / MM / DD YYYY
Student Information & Case Dismissed Information
Please list student information for a PDG to be removed because the case has been dismissed.
Student Full name
Student Number
Maximum of 9 digits allowed. Currently Entered: 0 digits.
Student Final Grade (no sanction applied):
Notes (Additional Information)
n/a Maximum of 250 characters allowed. Currently Entered: 3 characters.

LA&PS Pending Grade Request (PDG) Form

LA&PS Pending Grade Request (PDG) Form

Person Requesting PDG

Course Information

PDG Request

Student Information
Please list student information for a PDG to be mounted because of an alleged case of academic misconduct.

Student Information & Case Dismissed Information
Please list student information for a PDG to be removed because the case has been dismissed.

LA&PS Pending Grade Request (PDG) Form

LA&PS Pending Grade Request (PDG) Form

Person Requesting PDG

Course Information

PDG Request

Student Information Please list student information for a PDG to be mounted because of an alleged case of academic misconduct.

Student Information & Case Dismissed Information Please list student information for a PDG to be removed because the case has been dismissed.

Student Information
Please list student information for a PDG to be mounted because of an alleged case of academic misconduct.

Student Information & Case Dismissed Information
Please list student information for a PDG to be removed because the case has been dismissed.