This is a sample policy.  Prior to being adopted, it must be modified to ensure it is appropriate for use by the institution.

			
Name of Institution		Institution Number	

Dismissal Policy					
Name of Policy		Effective Date		Revision Date	

1.	[Institution name] may dismiss a student from a program on any of the following grounds:
•	[List the grounds on which a student may be dismissed]
2.	The process by which a student may be dismissed from a program is as follows:
•	[Describe the process by a which a student may be dismissed]