Revised on 10/27/21
Office of Registrar
C
ol
s
t
on Hall, Room
513
P:
718.
2
8
9
.5
710
F:
718.
2
8
9
.630
8
Select Requested Semester: SPRING
SUMMER
FALL YEAR
This form must be submitted to the Registrar’s Office via Document Upload in CUNYfirst. Students are responsible for claiming their
CUNYfirst Account. All BCC communication will be sent to your BCC student e-mail address. Starting fall 2013, students may choose
to continue their current academic plan or OPT IN to Pathways. Check with your Academic Advisor to discuss your options.
PART I: Contact Information
Student’s Name:
Last First Middle Initial
Current Address:
Street Address Apartment#
City State Zip Code
CUNYfirst EMPL ID#: Last 4 Digits SSN:
Email Address: Day and Month of Birth; /
Home Phone#: Cell Phone#:
PART II: College Information
What was the last term you attended Bronx Community College?
NOTE: If you last attended BCC beyond one calendar year, you MUST re-establish your Residency for Tuition purposes.
Go to http://www.bcc.cuny.edu/Registrar/?page=ResidencyForTuitionPurposes or speak with a Registrar representative for more details.
What was your Plan/Sub-Plan (major)?
If you are changing your major, complete and attach a Change of Plan form to this application.
NOTE: Students interested in majoring in Nursing, LPN, or Radiology Technology MUST fill out a Change of Plan form at the Registrar’s Office.
Admission to these majors must be approved by the Academic Department.
Did you attend another college since leaving Bronx Community College? Yes No
If yes, which college did you attend?
Did you graduate from that college? Yes No
NOTE: If the college you attended is a NON-CUNY school, you must submit an official sealed transcript to the Registrar’s Office for review, prior to
registration or advisement. If the college you attended is a CUNY school, you do not need to submit a transcript.
The above statements are true and complete to the best of my knowledge.
Student’s Signature: Date:
PART III: Dismissal
Dismissal Status – Students who have been dismissed from the college more than once must submit an Academic Appeal to the Appeals Agent of
the Committee on Academic Standing (CAS), via the online application at http://www.bcc.cuny.edu/academics/academic-advising/academic-
appeals/, for review prior to submitting the Readmission Application. Academic Appeals are facilitated under the purview of the Academic Success
Center in Sage Hall.
NOTE: If your academic appeal is granted by the Committee on Academic Standing (CAS), you may submit this application to the Registrar’s Office.
FOR OFFICIAL OFFICE USE ONLY – REGISTRAR’S OFFICE
Processed By: Date:
Registrar Representative’s Signature
$20 Non-Refundable Fee will be applied to your account.
