Fillable Peon for Re-Admission From Suspension (Tulsa Community College)

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Peon for Re-Admission From Suspension (Tulsa Community College)

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TULSA
COMMUNITY
COLLEGE
__________________________________________________________________________________________________________
Peon for Re-Admission From Suspension
Revised 4-19-18
Instrucons: Complete the enre form and submit to any campus Enrollment Services Oce along with any missing tran-
scripts. Peons and transcripts must be received at least 30 days before you wish to begin the enrollment process. The Peon
will be reviewed and the student will be noed of the next steps.
Full Name: ____________________________________________________________ Student ID Number: T__________________
Address: __________________________________________________________________________________________________
City/State/Province:_____________________________________________________________ Zip Code: ____________________
Home Phone: ______________________ Cell Phone: ______________________ E-mail Address: ___________________________
General Informaon
Which are you appealing? __ Academic Suspension __ Academic Dismissal (2nd Suspension)
Semester you wish to return to TCC : __ Fall __Spring __ Summer Year: _________
Campus you plan on aending: ____________________________________________
Number of course you wish to enroll in? __ (1) One __ (2) Two
What major are you pursuing? _________________________________________________________________________________
How many hours a week do you plan on working while aending school? ______________________________________________
Cizenship/Residency
Are you a U.S. Cizen? __ Yes __ No If No, list Visa Type: _________________________________________________
Are you an Oklahoma Resident? __Yes __ No How long have you lived in Oklahoma? __________________________________
Have you ever been convicted of a felony? __Yes __No
Educaon
Did you graduate from High School? __ Yes __ No If No, Did you earn a High School Equivalency Diploma? __ Yes __ No
School Name: __________________________________ City and State: _________________ Graduaon Date: ___________
List all Colleges and Universies you have aended:
College Name Dates of Aendance
**Any missing transcripts (High School/High School Equivalency/College) must be submied with re-admission packet **
If
my
pe
tition
is
approved, I understand I must maintain a 2.0
GPA
or
I
will
be placed
on
Academic Dismissal.
I understand
that
omissions
or
falsification
of
information on the re-admission packet
is
grounds
for
rejec
tion
of
the
petition
and/or
disciplinary action
of
an enrolled student.
All credentials
submitt
ed in support
of
this application become and remain
prop
erty ofTCC.
Signature:
___________________________
Date:
____________
_
*Digital Signature
not
accepted.
Return to:
Enrollment
Services
on
any campus
-OFFICE
USE
ONLY-
Campus:
_______
_
Acc
e
pt
ed by:
_____________________
Date:
______
_
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Essay Quesons Student Id Number: T_________________
What do you believe were the reasons for your unsasfactory academic performance from TCC?
Please explain what your personal and academic circumstances have been since your last aendance at TCC. In parcular, note
any experience that might help you succeed academically if given another opportunity to aend TCC.
If re-admied, what will be your plan to acon be for over coming problems that led to your poor academic performance or dismis-
sal? Note any addional steps you plan to take to enhance your chances for academic success.
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Peon for Re-Admission From Suspension (Tulsa Community College)

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Completed 3 February 2021

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