Application for Readmission
Disability Information
If you have a disability and may require accommodations, please submit a confidential written request for disabilities
accommodations. Written documentation of the disability is required. All documentation will be confidential and used only in
accordance with federal regulations; Section 504 of the Rehabilitation Act and Americans with Disabilities Act.
BCC Disabilities coordinator
Beaver Painted Lodge – Student Success Center
P.O. Box 819
Browning, Mt 59417
(406) 338-5421 Extension 2233
Safety and Security – All applicants must answer the following questions.
Have you ever been convicted of a felony (please include instances of deferred sentencing)? • Yes • No
A felony in Montana State Law is defined as a crime for which more than one year in prison may be imposed.
Have you been subjected to court-ordered confinement for threatening or causing physically or emotional injury to
persons or property? • Yes • No
Have you ever been disciplined, suspended from, or placed on probation at any educational institution for non-academic
reasons that results in a student leaving school for a fixed time, period, less than permanently. Dismissal from a college
for disciplinary reasons is defined as a permanent separation from an institution of higher education on the basis of
conduct or behavior. • Yes • No
Have you ever been required to register as a sexual or violent offender? • Yes • No
If you answered “yes” to any of the above questions, please provide and explanation with this application. Failure to do
so will delay the processing of your application.
An affirmative response to any of these questions will not automatically prevent admission, but you will be asked by BCC
to provide additional information. This information will be reviewed by a campus committee to ensure campus safety.
Any falsification or omission of data may result in a denial of admission or dismissal.
I hereby certify, to the best of my knowledge, the information on this application for readmission is true and complete,
without evasion or misrepresentation. I understand that, if it is later found otherwise, it is sufficient cause for rejection or
dismissal.
Date of application ________________________ Applicant’s Complete Legal Signature_______________________
If my application of readmission is approved, I agree to abide by the present and future rules and regulations both
academic and non-academic, and the scholastic standards of the appropriate institution, its colleges, schools, departments
and institutes, including, but not limited to those rules, regulations and standards stated in both the undergraduate and
graduate catalogs, I further acknowledge that, if I fail to adhere to these regulations or meet these requirements, my
registrations may be cancelled.
Date of application ________________________ Applicant’s Complete Legal Signature_______________________
REV 7.18
