Fillable Application for Reinstatement following Disciplinary Suspension following disciplinary (Los Medanos College)

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Application for Reinstatement following Disciplinary Suspension following disciplinary (Los Medanos College)

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Application for Reinstatement following Disciplinary Suspension
Students seeking reinstatement
following disciplinary suspension of more than 5 days must submit the following
application to the Office of the Dean of Student Success via email studentconduct@losmedanos.edu
or postal
mail. Once your application is received, it will be reviewed and you will be contacted for a required meeting
with the Dean to discuss your request.
IMPORTANT: Students who owe LMC money for past tuition, fees, or other debts will be unable to request
reinstatement until their debts are paid. If you have a debt on your student account, you must clear it before
your application will be accepted.
Name: ____________________________________________________________________________________
Address:
__________________________________________________________________________________
Email: _____________________________________________ Phone: _______________________________
Student ID#: ________________________________________
Attached please find my reinstatement application including my typed in responses to the three questions
below and all supporting materials pertinent to my request. I understand that the Dean of Student Success may
inquire further about my situation by communicating with any individual that I have referenced in my
application, as well as appropriate college personnel who may have relevant information regarding my situation.
I also understand that the Dean may share any or all information provided in my application with relevant
individuals in accordance with FERPA (Federal Educational Rights and Privacy Act) regulations.
_______
____________________________________ _______________________________
Signature Date
Required Questions:
Respond to the following questions with as much detail as you can.
1. Provide a thorough and reflective explanation of the factors that led to your suspension. Be specific
including the incident(s) that took place, the specific behavior(s)/action(s) that you engaged in, and the
college expectation(s) that you did not meet.
2. Why do you believe that you are now able to commit to the responsibilities and expectations required
of you by the Student Code of Conduct? What specific steps have you taken since your suspension to
ensure that you are prepared to fulfill the expectations of the Student Code of Conduct? How will you
ensure that you are able to fully follow the expectations of the Student Code of Conduct in the future?
• Additional: If you believe that physical or mental health issues were an important factor leading
to your suspension, please explain the steps you have taken to address them, and if relevant,
how you will manage them upon return (please include documentation if appropriate/available).
3. D
escribe your academic and career goals for returning to Los Medanos College. What is your timelin
e
fo
r accomplishing these goals?
Deadline & Instructions for Application Submission:
Applications for reinstatement must be submitted no later than 15 business days before the start of the term
that you wish to enroll in classes. Applications submitted after this deadline will not be considered.
S
tudents who have been suspended from Los Medanos College are not permitted on college property without
specific permission from the Dean of Student Success. Therefore, this application with all the supporting
documentation/attachments should be submitted via email studentconduct@losmedanos.edu
or postal mail.
Application Review Process:
After this application has been received it will be reviewed by the Dean of Student Success. Following the
review, applicants will be contacted to schedule a required meeting with the Dean to discuss their request.
Contact Information:
Office of the Dean of Student Success
Dave Belman, Dean
Los Medanos College
2700 East Leland Rd.
Pittsburg, CA 94565
R
oom: SS4-406
Temporary Phone (while Shelter-in-place): (925) 384-0507
Phone: (925) 473-7468
Email: studentconduct@losmedanos.edu
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Application for Reinstatement following Disciplinary Suspension following disciplinary (Los Medanos College)

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Completed 5 September 2020

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