Bucks County Community College
Cooperative Education Application

  1. It is your responsibility to obtain and refer to the appropriate fact sheet.
  2. Obtain an unofficial transcript
  3. Decisions are made on the basis of this application, so please fully complete this form and return it with a transcript to your Co-op Coordinator.
  4. Upon approval, you must obtain the necessary Co-op permit to enroll for this closed course. This can be obtained from the coordinator.

Student Information

Registration for Co-op (Course and Section)
Spring         Summer         Fall
Your Academic Department       
Your Career Field / Interest        
Student Number  
Name    
Address
City             State       Zip
Home Phone
I first found out about Co-op through    
Expected graduation date from BCCC  
Do you plan to work or continue your education after graduation    
My career goal is:    
I prefer working Part-time Full-time
    through the Co-op Program Beginning as early as (Date)    
If you are presently employed and prefer to use this position as your training for Cooperative Education,
        Please complete the following Information:
Firm Name 
Address      
City               State Zip
Firm Phone Number & Ext. 
Supervisors Name & Title
Your Starting Date      
Your Job Title at firm  
Instructor  Course
Instructor  Course
Student Signature __________________________________ Date _____________________

COORDINATOR USE ONLY

Application issued on
Advisors Name
GPA for accumulated courses
Co-op course prerequisites completed
Number of credits earned toward graduation
 
RECOMMENDATIONS
Student is NOT qualified for Cooperative Education at this time because of
Required credit hours not met at this time
Required courses have not been completed at this time
Required GPA (Grade point Average) is not obtained at this time
Other
 
Student IS RECOMMENDED with the following condition
 
Student IS RECOMMENDED for semester Spring Summer Fall
According to attachments and conditions above.

Complete this Application, Print and Mail to:

Bucks County Community College
Business Studies Dept.
275 Swamp Road
Newtown, PA 18940