HCI Reinstatement Application :: Healthcare Informatics Forms

Welcome to the reinstatement application for the Healthcare Informatics program. This form is for students who were previously admitted into the program and wish to resume their studies following a formal dismissal (if returning within four (4) quarters). If it has been more than four consecutive quarters, you will need to re-apply for admission to the program in order to continue. You will be required to meet the eligibility requirements in place for the most current application and supply new supporting materials. You will be charged the most current application fee and be placed on the most up to date degree worksheet.

Name*
First Last
Student ID Number (SID)*
BC Student Email*
We will communicate with you using your BC student email.
Which program option were you pursuing?*
When would you like to resume the program?*
Please indicate which enrollment status you are most interested in.*
To assist our scheduling and advising, please indicate if you plan to continue as a full-time student (3 courses per quarter-usually 15 credits) or part-time (1 or 2 courses per quarter- 5 to 10 credits).
- Full-Time
- Part-Time
Your status as a continued student in the program will be determined by your answers to the following essay questions; therefore, it is important that you be specific and thorough with your answers.
What changes do you plan to make in order to improve your academic success moving forward?*
What are your future professional goals and how do you plan to use this program to help you achieve them?*
What services can Bellevue College provide you to assist in the completion of your educational goal?*
If you are not familiar with the services Bellevue College offers, please refer to the BC website for more information. https://www.bellevuecollege.edu/resources/
Two (2) letters of recommendation are also required. Letters of recommendation should be on company letterhead, from someone who personally knows your work, such as a current or past supervisor or colleague, discussing your contributions to your work place and how he or she believes you will benefit from completion of the Healthcare Informatics program. Letters can also come from a current or former college instructor, on college letterhead.
Letter of Recommendation #1*
Accepted file types: doc, pdf, Max. file size: 5 MB.
Letter of Recommendation #2*
Accepted file types: doc, pdf, Max. file size: 5 MB.
Student Acknowledgements*
By "checking" each statement, you are signaling to us that you understand and accept all statements. It will be your responsibility to understand and fulfill all program requirements.
- I have read and understand the probation and dismissal policy for the Healthcare Informatics program as outlined in the Student Handbook: http://www.bellevuecollege.edu/hci/admitted-students/
- I understand that my reinstatement application must include my essay responses and letters of recommendation in ordered to be considered for review.
- I will make an earnest effort to regain good standing with the program.
- I understand that if I am reinstated, I am required to complete all coursework with a "C" grade (2.0) or higher. If I fail to do so, I will be subject to dismissal.
- If I am reinstated I understand that I will be enrolled on a probationary status.
Signature
Please type your full name to illustrate your formal e-signature. By signing, you are articulating that all fields completed above are correct and true.

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Last Updated August 6, 2018

HCI Reinstatement Application

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