Riverside Community College District
Honors Program Petition for
Special Admission
For office use only
If you do not currently meet the eligibility requirements, yet are still interested in the
Honors Program, complete and submit this form along with your Honors Program
application. Attach a single page, if necessary.
Name
Approved ____________
Denied ____________
Date ____________
_____________________________________________________________________________
Last name
First name
MI
Address _____________________________________________________________________________
Mailing Address
_____________________________________________________________________________
City
State
zip code
Phone
(_____)_____________
home
(_____)_____________
cell
RCC student ID __________________
Email
______________________________________________________________________________
1.
What are your educational goals and how does the RCCD honors Program fit into those goals?
2.
What aspect of the traditional eligibility requirements have you not met?
3.
Explain the circumstances that prevented you from meeting the traditional eligibility requirements.
4.
List the things that you will do to accomplish your educational goals and gain / maintain traditional program eligibility.
_____________________________________________________
Signature
______________________
date
Mail this petition along with your completed application and personal statement to:
Sylvia Thomas
Associate Vice Chancellor of Educational Services and District-wide Honors Coordinator
Riverside Community College District
1533 Spruce Street, Second Floor
Riverside, CA 92507
Attn: Debbie McDowell 951/222-8991
electronic submission can be made to: debbie.mcdowell@rccd.edu
attach completed form to e-mail | type Honors Application in the subject line
After submitting this petition, contact the Honors Coordinator on your campus to schedule a continued eligibility
conference and sign a Program Contract (contract only available from honors coordinator).
Moreno Valley College
Nick Sinigaglia | 951.571.6173
Nick Sinigaglia@mvc.edu
Norco College
Lyn Greene | 951.739.7846
Lyn.greene@norcocollege.edu
Riverside City College
Thatcher Carter | 951.222.8562
Thatcher.Carter@rcc.edu