Student Reactivation Form

Please Read Before Completing Form

If you are an undergraduate degree student and you have studied elsewhere since leaving ÁñÁ«ÊÓÆµ, or it has been 10 years since you first started at ÁñÁ«ÊÓÆµ, you must re-apply for admission to the college. 

Full Name
Home Address
Mailing Address

(If different from home)

Is this number a:
Since I last attended ÁñÁ«ÊÓÆµ:
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?