{"id":71,"date":"2018-08-06T16:24:15","date_gmt":"2018-08-06T16:24:15","guid":{"rendered":"https:\/\/forms.bellevuecollege.edu\/hci\/?page_id=71"},"modified":"2018-08-06T16:24:15","modified_gmt":"2018-08-06T16:24:15","slug":"hci-reinstatement-application","status":"publish","type":"page","link":"https:\/\/forms.bellevuecollege.edu\/hci\/hci-reinstatement-application\/","title":{"rendered":"HCI Reinstatement Application"},"content":{"rendered":"<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_6' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'>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). \r\nIf 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.\r\n<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_6'  action='\/hci\/wp-json\/wp\/v2\/pages\/71' data-formid='6' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_6' class='gform_fields top_label form_sublabel_below description_above validation_below'><li id=\"field_6_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_6_1'>\n                            \n                            <span id='input_6_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_6_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_6_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_6_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_82\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_82'>Student ID Number (SID)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_6_82' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_10\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_10'>BC Student Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_6_10'>We will communicate with you using your BC student email. <\/div><div class='ginput_container ginput_container_email'>\n                            <input name='input_10' id='input_6_10' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\" aria-describedby=\"gfield_description_6_10\" \/>\n                        <\/div><\/li><li id=\"field_6_84\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_84'>Which program option were you pursuing?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_84' id='input_6_84' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Healthcare Informatics, BAS degree' >Healthcare Informatics, BAS degree<\/option><option value='Healthcare Informatics Certificate' >Healthcare Informatics Certificate<\/option><option value='Healthcare Data Analytics Certificate' >Healthcare Data Analytics Certificate<\/option><\/select><\/div><\/li><li id=\"field_6_86\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_86'>When would you like to resume the program?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_86' id='input_6_86' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='Fall 2020' >Fall 2020<\/option><option value='Winter 2021' >Winter 2021<\/option><option value='Spring 2021' >Spring 2021<\/option><option value='Summer 2021' >Summer 2021<\/option><option value='Fall 2021' >Fall 2021<\/option><option value='Winter 2022' >Winter 2022<\/option><option value='Spring 2022' >Spring 2022<\/option><\/select><\/div><\/li><li id=\"field_6_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Please indicate which enrollment status you are most interested in.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_6_6'>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).<\/div><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_6'>\n\t\t\t<li class='gchoice gchoice_6_6_0'>\n\t\t\t\t<input name='input_6' type='radio' value='Full-Time'  id='choice_6_6_0'    \/>\n\t\t\t\t<label for='choice_6_6_0' id='label_6_6_0' class='gform-field-label gform-field-label--type-inline'>Full-Time<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_6_1'>\n\t\t\t\t<input name='input_6' type='radio' value='Part-Time'  id='choice_6_6_1'    \/>\n\t\t\t\t<label for='choice_6_6_1' id='label_6_6_1' class='gform-field-label gform-field-label--type-inline'>Part-Time<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_89\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >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. <\/li><li id=\"field_6_90\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_90'>What changes do you plan to make in order to improve your academic success moving forward?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_90' id='input_6_90' class='textarea medium'   maxlength='1200'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_87\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_87'>What are your future professional goals and how do you plan to use this program to help you achieve them?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_87' id='input_6_87' class='textarea medium'   maxlength='1200'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_91\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_91'>What services can Bellevue College provide you to assist in the completion of your educational goal?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_6_91'>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\/<\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_91' id='input_6_91' class='textarea medium'  aria-describedby=\"gfield_description_6_91\" maxlength='1200'  aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_95\" class=\"gfield gfield--type-html gfield_html gfield_html_formatted field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  >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\nplace 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. <\/li><li id=\"field_6_92\" class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_92'>Letter of Recommendation #1<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='5120000' \/><input name='input_92' id='input_6_92' type='file' class='medium' aria-describedby=\"gfield_upload_rules_6_92\" onchange='javascript:gformValidateFileSize( this, 5120000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_6_92'>Accepted file types: doc, pdf, Max. file size: 5 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_6_92'><\/div> <\/div><\/li><li id=\"field_6_94\" class=\"gfield gfield--type-fileupload gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_94'>Letter of Recommendation #2<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_fileupload'><input type='hidden' name='MAX_FILE_SIZE' value='5120000' \/><input name='input_94' id='input_6_94' type='file' class='medium' aria-describedby=\"gfield_upload_rules_6_94\" onchange='javascript:gformValidateFileSize( this, 5120000 );'  \/><span class='gfield_description gform_fileupload_rules' id='gfield_upload_rules_6_94'>Accepted file types: doc, pdf, Max. file size: 5 MB.<\/span><div class='gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty' id='live_validation_message_6_94'><\/div> <\/div><\/li><li id=\"field_6_98\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Student Acknowledgements<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_6_98'>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. <\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_6_98'><li class='gchoice gchoice_6_98_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.1' type='checkbox'  value='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\/'  id='choice_6_98_1'   aria-describedby=\"gfield_description_6_98\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_6_98_1' id='label_6_98_1' class='gform-field-label gform-field-label--type-inline'>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\/<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_98_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.2' type='checkbox'  value='I understand that my reinstatement application must include my essay responses and letters of recommendation in ordered to be considered for review.'  id='choice_6_98_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_98_2' id='label_6_98_2' class='gform-field-label gform-field-label--type-inline'>I understand that my reinstatement application must include my essay responses and letters of recommendation in ordered to be considered for review.<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_98_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.3' type='checkbox'  value='I will make an earnest effort to regain good standing with the program.'  id='choice_6_98_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_98_3' id='label_6_98_3' class='gform-field-label gform-field-label--type-inline'>I will make an earnest effort to regain good standing with the program.<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_98_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.4' type='checkbox'  value='I understand that if I am reinstated, I am required to complete all coursework with a &quot;C&quot; grade (2.0) or higher. If I fail to do so, I will be subject to dismissal.'  id='choice_6_98_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_98_4' id='label_6_98_4' class='gform-field-label gform-field-label--type-inline'>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.<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_98_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_98.5' type='checkbox'  value='If I am reinstated I understand that I will be enrolled on a probationary status.'  id='choice_6_98_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_98_5' id='label_6_98_5' class='gform-field-label gform-field-label--type-inline'>If I am reinstated I understand that I will be enrolled on a probationary status.<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_99\" class=\"gfield gfield--type-text field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_99'>Signature<\/label><div class='gfield_description' id='gfield_description_6_99'>Please type your full name to illustrate your formal e-signature. 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