Academic Renewal Application 
Admissions and Records
P. O. Box 80  Weyers Cave, VA 24486
(540) 234-9261/1-888-750-2722/ TDD 234-0848

This form requires a signature and cannot be transmitted electronically. Please complete the application, print, sign, and return to the above address.   
Last Name
First Name
Middle Initial
Social Security Number

As per 5.7.0.5 of the Virginia Community College System Policy Manual, I believe that I have met the following requirements for "Academic Renewal" and hereby petition to have my cumulative grade point average (GPA) adjusted accordingly:

  1. I have had a break in attendance at BRCC of five years (60 monthe) or more.

  2. I have earned a cumulative GPA of 2.5 in the first 12 credits immediately after re-enrolling at BRCC from my 5-year separation.

I further understand that in receiving an Academic Renewal adjustment to my cumulative GPA:

  • an Academic Renewal adjustment may be granted only one time;

  • once granted by the College, Academic Renewal cannot be revoked;

  • although my cumulative GPA will be adjusted in future terms, all of my previously earned grades will be shown on my permanent record;

  • any course credit with a grade of "D" earned during the Academic Renewal adjustment period will not count toward graduation requirements;

  • an "Academic Renewal" notation will be made on my permanent record; and,

  • the granting of Academic Renewal does not affect nay previous academic, financial, or administrative determination made by the College.

Student Signature
Date
For Office Use Only
Date received in Admissions & Records Office
Last semester enrolled prior to five year absence
First semester enrolled after five year absence
GPA for first 12 credits (or more) completed after return
Currently enrolled
Yes
No

Academic Renewal has been
Approved
Disapproved

The Academic Renewal was entered on your permanent record on .  You may request a copy of your transcript by following the Transcript Request procedures.

Coordinator of Admissions & Records
Data Entry Date