Note: Students must first be referred to the College Restoration Program by an academic department head before completing an application.
Complete this online application and submit it electronically.
Please list the name and phone number of the person we should contact in case of an emergency
Important note: Please read carefully and check the boxes below to confirm your agreement to the following conditions and policies.
Before submitting this form, please read the explanation of student rights under FERPA and CRP’s policies for sharing information related to academic performance.
All students wishing to participate in the College Restoration Program must submit this form no matter what the age or dependent status (unless you have a formal declaration of emancipation filed with the Registrar’s Office and do not want our office to contact your parents).
If you have filed a formal declaration of emancipation with the Registrar’s Office, please check here:
While I am in the College Restoration Program I,
, hereby give my permission to allow CRP faculty, staff, and mentors to share information relating to my academic performance with third parties. This includes, without limitation, my current quarter instructors, deans, department heads, academic coordinators and advisors, as well as my parents, RIT administrative offices such as Financial Aid, Registrar's, Student Financial Aid, Housing, Athletics, Disability Services, and Student Conduct.I understand that the Federal Educational Rights and Privacy Act of 1974 (FERPA) protects the privacy of my educational records and I specifically consent to the release of these records to third parties as mentioned in this application.
I understand that there will be at least three documents that will be sent to my parents: a welcoming letter, the Mid-Quarter Progress Note, and the CRP Final Report. In addition, I understand that if my parent/guardian calls/e-mails my CRP mentor or the Program Director, these people will return the call/e-mail and respond to any inquiry related to my academic performance. I also understand that this communication may include observations about my behavior in the classroom, professional opinions about my behavior as it relates to learning, disability information or medical/psychological information, and recommendations for further evaluation or for resources available to me at RIT. Any concerns regarding CRP’s policy can be directed to Dawn Herman, Program Director, CRP, 2140B SAU, 475-2982, firstname.lastname@example.org.
If you are eighteen years or older and/or a college student, the Federal Educational Rights and Privacy Act of 1974 (FERPA) protects the privacy of your educational records. Essentially, FERPA is “applicable to schools/colleges that receive federal funds (or their students receive federal funds)...and “provides parent/student access to educational records” ...while at the same time protecting “the privacy of those records.” (Nixon Peabody LLP 06/03)
In regard to our work with students in the College Restoration Program, FERPA allows us, the CRP faculty, staff, and mentors, to share
information of “legitimate educational interest” within RIT. This means we have the right to share information, such
as your transcript or academic advising report, and any further information, including our professional opinion, relating to your academic
progress or lack thereof on a “need to know” basis. Typically, we may share information with your current quarter instructors,
FYE coaches, department heads, and academic advisors. In addition, we may communicate with certain administrative offices such as Financial
Aid, Registrar’s, Student Financial Services, Disability Services, Housing, and Student Conduct. The type of educational records includes
your grades, grade point average (GPA), your course schedule, a record of misconduct (but not the specific behaviors) and any other
information relating to your academic performance.
In order for the ASC faculty, staff and mentors to work with students facing probation or suspension, we ask each applicant to sign and date
a Permission to Release Information form, no matter what the age or dependent status. Our communication with parents includes
a welcoming letter to verify the student’s participation in CRP, and copies of the Mid-Quarter Progress Note and the Final CRP Report which
are sent to parents as well as to the student. We will not conduct outreach to parents unless we suspect the student is in harm or harming others;
however, if a parent inquires, we will provide “educational information” on a “need to know” basis. We will not disclose
personal information unless it directly relates to academic performance. This includes our diagnostic opinions of behaviors suggesting a learning
or emotional disability. However, we may recommend that a student seek a professional evaluation and/or access campus resources available to them.
For students who have filed a formal declaration of emancipation with the Registrar’s Office, we will not send any correspondence to
parents. For students who are financing their college education, we still have the right to correspond with parents unless there is a
formal emancipation filed with the Registar’s Office. Any concerns regarding CRP’s policy can be directed to Dawn Herman, Director,
SAU-2140-B, 475-2982, email@example.com.
Students need to be aware that disclosing disability information or medical/psychological information in their final letter of appeal for reinstatement means that this information will be in their academic folder. Department heads, faculty, and advisors have legal right to access any information in the student’s academic folder since it is a formal “educational record.” We encourage students to avoid including personal information or any disability specifics in their letter. However, the final decision comes down to the student.
CRP faculty and mentors are also aware that they are often privy to sensitive information when working with their students in CRP. However, any formal reports will reflect their observations, professional opinions, and recommendations in general terms in order to respect the privacy of the student.
For further information on RIT’s and CRP’s compliance with the Family Educational Rights and Privacy Act of 1974 (commonly known as the Buckley Amendment), please see RIT’s “RIT Educational Records” in the handbook of Student’s Rights & Responsibilities.
I agree to the conditions and policies listed in the "Policies" section of this application.
All the information I have provided in this application is true to the best of my knowledge.