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Former Student Form
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This form is for former matriculated student seeking to re-enter a degree program after being away from FMCC for one semester or more.
Expected start term
Fall 2024
Personal Background
First Name
Middle Name
Last Name
Other Last Name Used (ex: maiden/ former name when last attending FMCC)
Suffix
Jr.
Sr.
I
II
III
IV
V
Preferred First Name
Birthdate
Birthdate
January
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Address
Primary Address
Primary Address
Country
Street
City
Region
Postal Code
Contact Information
Personal Email Address
Cell Phone
Additional Information
Were you academically dismissed from FMCC and requesting approval to return? (Student approved to return will be granted academic probation status and not permitted to enroll in on-line classes).
Were you academically dismissed from FMCC and requesting approval to return? (Student approved to return will be granted academic probation status and not permitted to enroll in on-line classes).
Yes
No
You must complete the following questions to formerly request approval to return to the College's Readmission Committee. A member of the readmission team will follow up with you regarding your application. Please note submitting this application is in no way an acceptance to the college.
Which of the following contributed towards your inability to meet the standards for academic progress? Please check all that apply.
Which of the following contributed towards your inability to meet the standards for academic progress? Please check all that apply.
COVID related circumstance (required remote learning environment, illness, care for a family member, homeschool children,…)
Lack of access to technology (WiFi, no computer,…)
Unable to balance work and school responsibilities
Schedule conflicts (work, personal,...)
Financial stress
Unable to or did not use academic tutoring
Inadequate childcare
Personal issues
Transportation
Extenuating Circumstances such as family illness, job responsibilities changed, ... (Please indicate the circumstances below).
Tell us specifically why you feel you were unable to meet your academic goals previously? Please be specific and elaborate when necessary.
If approved, what specific action steps do you plan to take or change to overcome the obstacles that contributed towards your previous academic difficulties. (Trying harder is not a sufficient response).Please be specific and describe what actions you may have already taken to ensure success.
I certify that the information provided is true and that the application and
student statement are my own work. If granted Academic Readmission (Probation) I agree
to follow the recommendations outlined in my Academic Success Plan developed
with me by an advisor and/or the Readmission (Probation) Committee. My failure to follow
my Academic Success Plan may result in my loss of Academic Probation,
matriculated status, and eligibility for financial aid. Students granted academic
readmission (probation), are not permitted to enroll in on-line classes.
I certify that the information provided is true and that the application and
student statement are my own work. If granted Academic Readmission (Probation) I agree
to follow the recommendations outlined in my Academic Success Plan developed
with me by an advisor and/or the Readmission (Probation) Committee. My failure to follow
my Academic Success Plan may result in my loss of Academic Probation,
matriculated status, and eligibility for financial aid. Students granted academic
readmission (probation), are not permitted to enroll in on-line classes.
Yes
Academic Information
Degree Program Looking to Pursue
Select program
Accounting AAS
Accounting Clerk - Individual Studies Certificate
Addiction Services AAS
Addiction Services Certificate
Art Gallery Management - Individual Studies Certificate
Assistant Horticulturist - Individual Studies Certificate
Bank & Financial Teller - Individual Studies Certificate
Business Administration AS
Business Applications Specialist Certificate
Business Marketing & Management AAS
Cannabis Cultivation Technician - Individual Studies Certificate
Cannabis Dispensary Manager - Individual Studies Certificate
Computer Information Systems AAS
Computer Networking & Cybersecurity AS
Computer Science AS
Craft Brewery Management - Individual Studies Certificate
Criminal Justice AAS
Criminal Justice AS
Customer Services Representative - Individual Studies Certificate
Dental Assistant - Individual Studies Certificate
Direct Support Professional (DSP) - Individual Studies Certificate
Early Childhood Education AAS
Early Childhood Education Certificate
Education Transfer Path – General Studies AA
Electrical Technology AAS
Emergency Dispatcher - Individual Studies Certificate
English Transfer Track - General Studies AA
Entertainment Technology AAS
Fine Arts AS
General Education Certificate
General Studies AA
Health Information Records Management AAS
Health Sciences AS
Health Studies AAS
Heating, Ventilation, Air Conditioning, & Refrigeration Technology (HVAC/R) Certificate
Human Services AAS
Human Services AS
Individual Studies: Collaborative Career Learning AOS
Individual Studies: Collaborative Career Learning Certificate
IT Support Technician - Individual Studies Certificate
Media Arts & Digital Technology AAS
Medical Administrative Assistant/ Medical Secretary - Individual Studies Certificate
Medical Records and Health Information Technician - Individual Studies Certificate
Nursing AAS
Patient Care Technician - Individual Studies Certificate
Phlebotomist - Individual Studies Certificate
Physical Education & Sport Management AS
Psychology Transfer Track - General Studies AA
Quality Assurance Lab Technician - Cannabis - Individual Studies Certificate
Quality Assurance Lab Technician - Dairy - Individual Studies Certificate
Quick Service Food Manager - Individual Studies Certificate
Radiologic Technology AAS
Restaurant Management - Individual Studies AOS
Salon Industry Entrepreneurship - Individual Studies AOS
Social Media Specialist - Individual Studies Certificate
Supply Chain - Individual Studies AOS
Supply Chain - Individual Studies Certificate
Teaching Assistant Certificate
Teaching Assistant for the Deaf - Individual Studies Certificate
Veterinary Assistant - Individual Studies Certificate
Full-time or Part-time
Full-time or Part-time
Full Time
Part time
I certify that the information on this request to return form is correct. False information or omission of data may result in denial of readmission or dismissal from the college.
By typing your name below, you hereby certify the above statement.
aapp submitted
aapp submitted
Yes
No
Submit