Education Experience Appeal Form PDF Details

When seeking a new position in the education field, you will likely be required to complete an education experience appeal form. This form is used to determine if your previous experiences and coursework meet the necessary requirements for the desired position. Completing this form can seem overwhelming, but with a little time and effort, you can ensure that your application stands out among the rest. In this blog post, we will provide an overview of the education experience appeal form process, as well as some tips for completing it successfully. Keep reading to learn more!

QuestionAnswer
Form NameEducation Experience Appeal Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesfidelis claims reconsideration form, fidelis reconsideration form 2021, fidelis appeal form 2021, fidelis authorization form

Form Preview Example

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

Month Year

Month Year

Month(s) Year(s)

 

 

Qualifying Experience

 

 

 

Describe each of your duties separately with percentages (Required for Rating).

% Time

 

 

 

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):

GED

High School

Vocational High School

Trade School

Associates Degree

Bachelors Degree

Masters Degree

I do not have a diploma or degree

Dates of attendance: From ____/____ To ____/____

Date of Graduation: ____/____

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 .