Navigating the complexities of qualification processes can sometimes be a challenging endeavor, especially when you believe your education and experience have been undervalued or misjudged. Fortunately, the Education Experience Appeal form is designed to address such concerns, offering individuals a structured method to appeal their disqualification in cases where they believe their qualifications have not been accurately assessed. This form, which must be filled out meticulously in either black or blue ink, covers multiple sections – each tailored to address specific qualifications from employment history, foreign education, to the very details of one's educational background, including degrees and diplomas. It even provides a space for individuals to contest errors in the evaluation process of their original application. By allowing appeals on various fronts, such as employment qualifications disqualification, the necessity of foreign education evaluation, or inaccuracies in recognizing academic credentials, the appeal form plays a pivotal role in ensuring that every candidate's qualifications are given a fair reassessment. Additionally, the emphasis on anonymity and the prohibition against writing one's name on the form underscores a commitment to an unbiased review process. The detailed instructions guide applicants on how to articulate their qualifications and employment experience efficiently, ensuring a comprehensive representation of their capabilities and achievements.
| Question | Answer |
|---|---|
| Form Name | Education Experience Appeal Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | fidelis claims reconsideration form, fidelis reconsideration form 2021, fidelis appeal form 2021, fidelis authorization form |
Use this form to submit your appeal
ED U CATI ON AN D EX PERI EN CE APPEAL FORM
Do Not Write Your Name Anywhere On This Form.
Print All Required Information In Black Or Blue Ink.
Social Security Number _ _ _- _ _
Exam Title _________________________ Exam Number _ _ _ _
SECTION 1 – EMPLOYMENT
I am appealing my disqualification for not indicating that I possess the minimum employment qualification requirements.
Qualifying Employment: Job Title: ___________________Name of Employer: _________________
Address of Employer:_________________________________________________________________
Nature of Employer's Business: ____________________ Number of Hours Worked per Week: ______
Dates of Employment - From: ____/____ To: ____/____ |
Total Time: ____/____ Presently Employed |
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Month Year |
Month Year |
Month(s) Year(s) |
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Qualifying Experience |
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Describe each of your duties separately with percentages (Required for Rating). |
% Time |
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Total Time Spent Performing These Duties =
100%
I f y ou n eed m or e space, at t ach addit ional Educat ion and Ex per ience Appeal For m s. Be sur e t o include y our social secu r it y num ber , t he ex am t it le and num ber on each at t ached sheet .
Use this form to submit your appeal
SECTION 2 – FOREIGN EDUCATION
I am appealing my disqualification for not submitting an evaluation of my foreign education. I am having an evaluation of my foreign education submitted directly to MTA New York City Transit by an approved evaluation service.
SECTION 3 – EDUCATION
I am appealing my disqualification for not possessing the required credits, hours, diploma or degree.
The diploma or degree that I possess that I need to qualify is (only check one box):
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GED |
High School |
Vocational High School |
Trade School |
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Associates Degree |
Bachelors Degree |
Masters Degree |
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I do not have a diploma or degree
Dates of attendance: From ____/____ To ____/____ |
Date of Graduation: ____/____ |
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Month Year |
Month Year |
Month Year |
Name of Educational Institution: _________________________________ USA Foreign
Address of Institution: __________________________________________________________
Section 3A: Vocational High School/Trade School Specialty___________________________
Number of hours you completed in specialty: ________
Section 3B: College/University Major_____________________________________________
Number of Credits Completed in Major: ______ Total Number of Credits Completed: _______
Title of Degree: _______________________________________________________________
SECTION 4 – ERROR IN EVALUATION
If you believe that we have made a mistake in the way we evaluated the information you provided to us, you should use the box below to notify us of our mistake.
I f y ou n eed m or e space, at t ach addit ional Educat ion and Ex per ience Appeal For m s. Be sur e t o include y our social secu r it y num ber , t he ex am t it le and num ber on each at t ached sheet .