First and Last Name:

ACC eID:

Mailing Address:

City:

State:

Zip Code:

Phone Number:

Email Address:

Course number of last successfully completed course:

Site/Track of last course completed:
Onsite - RRCOnsite - CECOnsite - EVCMobility

Semester and year of the last course enrolled:

Course number for which re-enrollment is requested:

Site/Track requested for re-enrollment:
Onsite - RRCOnsite - CECOnsite - EVCMobility

Requested semester for re-enrollment course:
SpringSummerFall

Reason for re-enrollment in course:

I understand that I am only allowed to re-enroll in a Professional Nursing course one time.
I understand that I am only allowed to re-enroll in a total of 10 semester hours in a Professional Nursing program.
I understand that the deadlines to request re-enrollment in a course are December 11 (for Spring) and May 14 (for Summer and Fall).
I understand that my request for re-enrollment will be ranked according to my priority rating (see Professional Nursing Handbook), then by grade or standing in the course(s) at the time of withdrawal.
I understand that the Admissions Committee may approve or deny my request for re-enrollment based on my past performance in a Professional Nursing program.
I understand that if my request for re-enrollment is approved, the Admissions Committee may require additional course work, medication examination, or check-off as a condition of re-enrollment.
I understand that if my request for re-enrollment is approved, registration in the course(s) is permitted only if space is available.
I have read the re-enrollment policy as outlined within the current Professional Nursing Student Handbook.
I understand that I will receive notice as to whether space is available for re-enrollment by the Nursing Office one month prior to the start of the semester.
I understand that I am not to register until I am given WRITTEN PERMISSION that space is available for me. (You will be dropped by the Professional Nursing Department if you register before permission is given.)

Comments (optional):

First and Last Name:

ACC eID:

Mailing Address:

City:

State:

Zip Code:

Phone Number:

Email Address:

Course number of last successfully completed course:

Site/Track of last course completed:
Full-time HybridFull-time OnsitePart-time Hybrid

Semester and year of the last course enrolled:

Course number for which re-enrollment is requested:

Site/Track requested for re-enrollment:
Full-time HybridFull-time OnsitePart-time Hybrid

Requested semester for re-enrollment course:
SpringSummerFall

Reason for re-enrollment in course:

I understand that I am only allowed to re-enroll in a Professional Nursing course one time.
I understand that I am only allowed to re-enroll in a total of 10 semester hours in a Professional Nursing program.
I understand that the deadlines to request re-enrollment in a course are December 11 (for Spring) and May 14 (for Summer and Fall).
I understand that my request for re-enrollment will be ranked according to my priority rating (see Professional Nursing Handbook), then by grade or standing in the course(s) at the time of withdrawal.
I understand that the Admissions Committee may approve or deny my request for re-enrollment based on my past performance in a Professional Nursing program.
I understand that if my request for re-enrollment is approved, the Admissions Committee may require additional course work, medication examination, or check-off as a condition of re-enrollment.
I understand that if my request for re-enrollment is approved, registration in the course(s) is permitted only if space is available.
I have read the re-enrollment policy as outlined within the current Professional Nursing Student Handbook.
I understand that I will receive notice as to whether space is available for re-enrollment by the Nursing Office one month prior to the start of the semester.
I understand that I am not to register until I am given WRITTEN PERMISSION that space is available for me. (You will be dropped by the Professional Nursing Department if you register before permission is given.)

Comments (optional):