Troy Publication 384-236
Revised 9/2010
READMISSION TO GRADUATE SCHOOL APPLICATION
Students who have been academically suspended must submit this form to the Graduate School as part of their readmission packet.
Students who have not been enrolled at Troy University for one or more years must submit this form to the campus Records Office where they plan to re-enroll.
(Students who have not enrolled at Troy University for three or more years see note under Item #4)*.
1. Campus at which you plan to attend (Home campus / Site):
Dothan
Montgomery
Phenix City
Troy
eCampus
Global Campus / Indicate Site
2. Campus at which you last attended:
3. Request Readmission to Troy University
Semester or Term :
Year:
4. Intended Graduate Program*:
*NOTE: Students who have not enrolled at Troy University for three or more years must meet all degree requirements current at the time of readmission.
5. Name:
Last
First
Middle
6. Social Security Number (If applicable):
Troy University attempts to minimize the use of social security numbers for security purposes and applicants are not required to submit this
information. However, applicants who are applying for federal financial aid must provide social security numbers in order for the Office of Financial
Aid to retrieve appropriate data from the U.S. Department of Education.
7. Home/Permanent Address:
Street
City
State
Zip
State
Zip
8. Current Mailing Address:
Street
9. Email:
City
Home Phone:
Cell Phone:
Work Phone:
10. Current Employer:
11. Have you enrolled with an other college or university since last enrollment with Troy University?
Did you attend as a transient student?
Yes
No
Yes
No
If the answer is yes to either question above, list the institutions and provide an unofficial copy of the transcript with this Readmission to Graduate
School Application. Official copies of the transcripts must be sent to the Admissions Office prior to a formal readmission being granted.
Institution
City, State
Student's Signature _______________________________________________________________
Dates Attended
Degree Earned
Date ___________________________
RECORDS OFFICE USE ONLY:
Readmission approved for ________________________________ (Campus/Site)
_____________________( Semester/Term)
Student qualifies to seek degree under the ___________________Graduate Catalog.
Readmission denied. Reason: ___________________________________________________________________
Contact Information ___________________________________________________________________________
Admissions Officer _________________________________________ Date _______________________________
____________(Year)