Re-entry Application

Re-entry Application

Any degree-seeking student who has previously taken classes at University of the Potomac must complete this application before being re-admitted. LETTER OF INTENT MUST BE ATTACHED TO THIS FORM.
Name*

First NameMiddle NameLast Name
Student ID*
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Last Term Enrolled at University of the Potomac?
Year (YYYY)*
Term*
Date:*
MM-YYYY
Program/Concentration previously enrolled:*
Are you planning to change program or concentration?*

YesNo
*Please note your program requirement and tuition/fees are subject to change. Talk to your academic advisor before making changes.
Change my program to:
Change my concentration to:
In accordance with the Americans with Disability Act (ADA), will you require any reasonable accommodations from the University of the Potomac*

YesNo
Desired Enrollment Date at University of the Potomac?
Year (YYYY)*
Term*
Date:*
MM-YYYY
Preferred Status?*
Current Campus*
I have NOT attended any university since I left University of the Potomac.I have attended any university since I left University of the Potomac.
School Name, State
Dates Attended

MonthDayYear
Date
Degree Earned (if applicable)
Need more...

YesNo
School Name, State
Dates Attended

MonthDayYear
Date
Degree Earned (if applicable)
Student Services Email
By checking these boxes below:*

I understand that all holds/suspensions on my account must be resolved before I can be re-admitted to the University of the Potomac.I understand that, as part of my re-entry process, I need to submit a Re-entry Letter of Intent. The letter will be reviewed along with my Re-entry application by the Re-entry Acceptance Committee.
Student Signature*

Clear
Date:*

MonthDayYear

Letter of Intent

As part of my re-entry process, a Letter of Intent must be submitted. The letter will be reviewed along with a completed Re-entry application by the Re-entry Acceptance Committee.
Student Name:*

First NameLast Name
Student ID*
When writing your letter, make sure you answer the following questions. Use the back of the page if needed (500 words max.)
- Explain the circumstances that led to your withdrawal from the University, and how those circumstances have changed?
- What are your career plans? What made you choose this program of study?
- Explain your plan to ensure future academic success?
0/500
Student Signature*

Clear
Date:*

MonthDayYear
DSO (If applicable): ____________________ [ ] Approved [ ] Denied

Student Finance: _______________________ [ ] Approved [ ] Denied

Academics: ___________________________ [ ] Approved [ ] Denied

Courses: _______________________________

Registrar: _____________________________ [ ] Approved [ ] Denied

Help Desk: ____________________________________________________

Student Services: _______________________ [ ] Approved [ ] Denied

Comments: ________________________________
Should be Empty: