Suspension Reinstatement Form

SUSPENSION REINSTATEMENT FORM

In order to promote each student’s chance of academic success, Bluegrass Community and Technical College requires a written request for readmission from students returning from suspension. Each situation is handled individually, and the conditions of reinstatement may vary from student to student.

PLEASE PRINT OR TYPE:

NAME: ________________________________________________________________

MAILING ADDRESS: _____________________________________________________

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SOCIAL SECURITY NUMBER: __________- _______-__________

LAST SEMESTER AT BCTC: ________________________________

HAVE YOU BEEN SUSPENDED FROM BCTC BEFORE THIS TIME? ____________

If yes, how many times? ______________

ON THE SECOND PAGE OF THIS FORM, PLEASE DISCUSS THE REASON(S) WHY YOU WERE ACADEMICALLY UNSUCCESSFUL DURING YOUR PREVIOUS ENROLLMENT AT BLUEGRASS AND WHAT IS YOUR PLAN OF ACTION TO BE SUCCESSFUL IF GIVEN THE OPPORTUNITY. (Please print or type and return this form to the Admissions Office, 200 Oswald Building, 470 Cooper Drive, Lexington, KY 40506-0235 by the designated deadline in the letter.)

If reinstated, how many credit hours do you plan to take during your first semester? ______________

Please read and fill in the blank in the following statement and sign the bottom of this form:

I, _______________________________________ , request to be reinstated to Bluegrass Community and Technical College. If reinstated, I understand that I must receive at least a 2.0 semester grade point average every semester beginning with the _____________________ semester.

________________________________________ _______________________________

Signature of Student Date

FOR OFFICE USE ONLY

__________________ ____________ ____________________________________

Sem. Request for Rein. Date Reviewed Signature of ASAP Member

# of Susp. _____ Rein. _____ Cond. Rein. _____ GE 101 _____ Study Skills __________

COUN. _____ DS _____ HR. Limit _____ Bank. _____ R.O. _____ Re-Write _____

Not Rein. _____ Reason: ___________________________________________________

SUSPENSION REINSTATEMENT FORM

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