StudentsFaculty/StaffParents

College Restoration Program Referral Form

In order to schedule students as soon as possible, complete this form and tell the student to go to the CRP web site to complete an online application at http://www.rit.edu/asc/crp_application.php.

Once we receive both the department's referral and the student's application/questionnaire, the student's name goes on the "ACTIVE" A-list. We will contact all eligible students on the A-list to schedule intake testing and a scheduling conference. We take up to 50 eligible students per quarter on a first come first served basis. For questions, please contact 475-2982, Dawn.Herman@rit.edu or the ASC Staff Assistant, 475-5536, asc@rit.edu.


Student's Name:
College:
Major:
Quarter:
 
Student is facing:
(check one)
 Academic Suspension
Probation
Other

BACKGROUND INFO

Please provide any insight you may have about the factors that contributed to this student's academic difficulty, i.e., personal problems, attitude, developmental problems, career issues, basic skills, study strategies, time management, financial problems, etc.

EXIT OPTIONS

(Please check all that may apply)

Return to referring department upon meeting conditions stated below.
Student may not return to referring department.
Apply for internal transfer to another RIT program.
Name of program:  
Explore other majors, such as:  
Explore other options outside of RIT.
Other. Please elaborate:  

REINSTATEMENT CONDITIONS

Student must achieve a minimum of the following conditions in order to be considered for reinstatement/internal transfer. (check all that apply)

Min. GPA
for CRP classes		Min. GPA
for credit classes		Min.
Cumulative GPA		Lowest
Grade
2.0
2.5
3.0
Other
 2.0
2.5
3.0
Other
 2.0
2.5
N/A
Other
 D
C
B
Other

RECOMMENDED CREDIT COURSES

The student will be placed in 1 or 2 RIT credit courses in order of department's preference if possible.

1.   3.  
2.   4.  

Name of referring person:  
Office address:      Phone:      E-mail: