Student Reactivation Form

Please Read Before Completing Form

If you are an undergraduate degree student and you have studied elsewhere since leaving Â鶹ԭ´´, or it has been 10 years since you first started at Â鶹ԭ´´ you must re-apply through the admissions office. 

Home Address
Mailing Address

(If different from home)

Is this number a:
Since I last attended Â鶹ԭ´´:
I am reactivating as an:
I would like to reactivate and begin taking classes in the:
Since your last enrollment, have you been adjudicated guilty or convicted of a misdemeanor or felony?