Application for Admission after Suspension of Dismissal for Student Conduct Form

Application for Admission after Suspension or Dismissal for Student Conduct

This form is designed for students who are seeking admission following dismissal or suspension due to student conduct. It allows you to provide details about the reasons for your conduct, any changes in your circumstances, and your commitment to meeting expectations upon being enrolled. Please fill out this form completely note that all documents submitted become the property of Tidewater Community College.

Requesting enrollment for

Summer

Fall

Spring

Year

Name

First Last

Student Identification Number(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home or Cell Phone

VCCS Email(Required)

@email.vccs.edu

List any colleges or universities from which you have been suspended(Required)

College or University (Old Dominion University)

City ( ex. Norfolk)

State (ex. VA)

Dates Attended (Spring 22 – Spring 24)

Explain the reason(s) you are requesting enrollment at TCC(Required)

How have your circumstance changed so that you now feel you are capable of succeeding at TCC?(Required)

FERPA Consent to Release Educational Records

Instructions:
Log into MyTCC: http://tcc.my.vccs.edu
Launch SIS (Student Information System)
Click the “Student Records eForms” block
Click “Add a FERPA eForms” from the menu
Verify your student Information
Choose “Tidewater Community College” from the Academic Institution drop down box
Read all instructions on the page to your Authorized Person(s)
Please note that is you put your own name; your request will be denied.

If admitted to TCC, I understand that I am responsible for upholding the expectations outlined in the Code of Student Rights and Responsibilities. Please sign.(Required)