Student Status Reinstatement Request Form
Submit your request to reinstate your academic status. Please complete all required sections accurately to ensure timely processing.
Full Name
*
First Name
Last Name
Student ID Number
*
University Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Current Academic Status
*
Please Select
Suspended
Withdrawn
Dismissed
Other
Last Term Enrolled (Semester and Year)
*
Reason for Reinstatement Request
*
Supporting Explanation or Circumstances
Upload Supporting Documents (if any)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Preferred Term for Reinstatement
*
Please Select
Fall
Spring
Summer
Submit Request
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