Application for Reinstatement

1. Schedule an appointment with a Counselor. Call the Counseling Center at 201-447-7211.
2. Complete this Reinstatement Application.
3. Pay the $25.00 Reinstatement Fee at the Bursar's Office, A229.
4. Bring this completed Reinstatement Application to the Counseling Center when you meet
with a Counselor.
5. The Counselors have the authority to reinstate most students on behalf of the Academic
Standing Committee. Some Reinstatement Applications will be referred to the Academic
Standing Committee, which meets monthly during the Fall and Spring Semesters. The
Counselor will advise you of the appropriate procedures and conditions for reinstatement.
6. Refer to the Bergen Community College Catalog for Academic Standing regulations.

If you are approved for reinstatement, the conditions of your enrollment are determined
at the discretion of the Academic Standing Committee or a College Counselor. The
decision will be based on a review of your grades to date and of the merits of the appeal
you present in writing.

You are advised to carefully review your situation. Your response to each of the items should
be thorough and specific. You are encouraged to attach pertinent documentation to support your
appeal. The College reserves the right to request official documentation when appropriate.

Requesting Reinstatement for Fall ______ Spring _________ Summer ______ Year: ________

Name __________________________________________ Student ID/SS# ___________________

When Did You First Enroll At Bergen Community College? Semester ________ Year: ________

Current Status (Check One):
__ Suspension __Dismissal At the end of ____Fall ____ Spring Year: _______

Please indicate if you are receiving financial assistance:
____ EOF ____Financial Aid /VA Other ________________________

Are you an International Student on a Visa? _____ Yes _____ No

1. Explain the reasons why your academic performance was below the level required by
college regulations.

2. How have your circumstances changed so that you now feel you are capable of improving
your cumulative grade point average to the acceptable level?

3. If reinstated, you are expected to repeat courses in which you received "E", "R", or "F"
grades. If there are other courses you wish to take, please list the courses requested and reasons
for your request.

If reinstated, I understand that I have made a contract with the college to raise my grade point
average, and to meet specific requirements outlined by The Academic Standing Committee or
College Counselor.

________________________________

Student Signature

____________________

Date

COLLEGE PERSONNEL ONLY

Credits Attempted At BCC _____________ Credits Completed At BCC ___________________
Cumulative Grade Point Average ________ Program __________________________________

_____ Grant _____ Deny ____ Table (Reason) ______________________________
Semester/Year ________________

Restrictions: Credit Limit ____________
Specific Courses (Includes Repeats) ________________________________________________________________________________________________________________________________________________________________________

Courses Requiring Divisional Approval (Second Repeat) ________________________________________________________________________________________________________________________________________________________________________

Grade Point Average Requirements _______________ Semester ______________ Cumulative

Other: ______________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

__________________________
Authorized Signature

______________________

Date