UNDERGRADUATE APPLICATION FOR READMISSION
Savannah State University
Office of the Registrar
Box 20479
Savannah, GA 31404
Email:
[email protected]
Phone:
(912) 358-4153
Fax:
(912) 358-3165
Website: www.savannahstate.edu
General Information
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Applications for Readmission must be submitted at least twenty days prior to the start of the academic term for which
applicants request readmission.
Transient and Armstrong Atlantic State University (AASU) Exchange students must attach a Transient/Letter of Good
Standing form to this form for each term of enrollment.
Students seeking financial aid must complete and submit a FAFSA.
Students who are on financial aid suspension must also complete a Financial Aid Appeal application with the Office of
Financial Aid.
All name changes must be accompanied by legal documentation.
Readmission decisions will be communicated to applicants via U.S. Mail at the address provided in this application
form.
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Legal Name:
Last
First
Middle
Jr., III, etc.
(Please indicate all other names used)
Student Identification Number
9
Date of Birth
1 5
Application Type (Check One)
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Transfer/Readmit (no other college(s) attended since last date of attendance at SSU-send completed application to
Registrar’s Office)
Transfer/Readmit (other college(s) attended since last date of attendance at SSU-send completed application along
with official academic transcripts to Office of Admissions)
Term you plan to enter: Fall Semester 20____ Spring Semester 20____
Summer Semester 20____
Major:
Mailing Address
Street
City
County
State Zip
Country (if not USA)
Legal Residence
City & State or Country (if not USA)
Phone Numbers (please include area codes)
Home
/
Cell/Other
Email Address: ___________________________________________________________________________________________
Ethnic Origin (Optional; used for statistical purposes only and is not considered in readmission decision) :
(Circle one)
American Indian
Alaska Native
Asian
African-American Hispanic White
Multi-Racial
Sex (Optional, for statistical purposes only and is not used for readmission decision) (Circle one)
Male
Pacific Islander
Other
Female
Citizenship Status: (Circle one) U.S. Citizen
Resident Alien*
Non-Resident Alien**
Country of Citizenship: ___________________________________________
*If Resident Alien, please attach a copy of both sides of Alien Registration Receipt Card I-151)
**If Non-Resident Alien please indicate: Visa Type: ____________ Expiration Date: _________________________
Residency Status
Are you a legal, permanent resident of Georgia? Yes ___ No _____ If yes, of what county? _______________________
If yes, how long have you lived continuously in Georgia immediately prior to this application? _________________
If no, of which state are you a resident? ________________
Are you applying for in-state tuition? (Check One) Yes_____ No _____
Verification of Lawful Presence
In accordance with Board of Regents Policy 4.3.4, all applicants who are accepted for admission or readmission to Savannah
State University and who seek to be classified as in-state for tuition purposes, will be required to provide validation of residency
and lawful presence in both the State of Georgia and the United States. Acceptance to Savannah State University may be
delayed until lawful presence is verified.
The U.S. Department of Education will automatically validate the lawful presence of any student who completes a FASFA
application; therefore, if you are applying for financial aid it will not be necessary for Savannah State University to perform
additional verification of your residency status. Otherwise, you will be required to submit one of the following documents to the
Registrar’s Office:
 Certified U.S. Birth Certificate (no photocopies)
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 GA Driver’s License (issued after 1/1/2008)
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 GA ID Card (issued after 1/1/2008)
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 Current U.S. Passport
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U.S. Certificate of Naturalization (USCIS form N-550
or N-570)
U.S. Certificate of Citizenship (USCIS form N-560 or
N-561)
U.S. Certificate of Birth Abroad issue by Dept. of
State (DS-1350)
Consular Report of Birth Abroad (FS-240)
Have you ever attended Savannah State University? If so, when did you last attend? Semester/year ___________/________
Have you attended any other college or university since you last attended Savannah State University? Yes No
If you answered “Yes” to the previous questions, please list all colleges or universities attended and provide the approximate
dates you attended in the space below (please use additional sheets if necessary):
1.
___________________________________________________________ _______________________________
College/University
2.
___________________________________________________________ _______________________________
College/University
3.
Dates of Attendance
___________________________________________________________ _______________________________
College/University
4.
Dates of Attendance
Dates of Attendance
___________________________________________________________ _______________________________
College/University
Dates of Attendance
Official transcripts must be sent directly to Savannah State University from ALL institutions listed above. If your last date of
attendance at SSU is more than five (5) years ago, you will be required to request and submit transcripts of academic work.
Failure to notify SSU of attendance at another institution will result in denial of credit for such work and may lead to
immediate dismissal.
Were you academically suspended or dismissed from SSU or any of the institutions listed above?
Yes No
If yes, please attach an explanation of your suspension or dismissal and detail your academic plans and what you will do to be
successful if allowed to enter SSU. If you have been suspended or dismissed and your application does not include the requested
narrative, it will not be considered.
Have you ever been convicted of a felony?
Yes No
If you answered yes to the above question, please attach a written statement with details of your conviction to this application.
I understand that any material false statement made knowingly and willfully by me on this application, or any documents
attached hereto may, in accordance with O.C.G.A. 16-10-71, which provides that upon conviction, a person who
knowingly commits the offense of false swearing shall be punished by a fine of not more than $1,000 or by imprisonment
for not less than one nor more than five years, or both, subject me to prosecution in a court of law. Additionally, I further
understand that any such false statement may subject me to denial of admission or immediate dismissal from the
institution.
Further, I certify that, to the best of my knowledge, the information submitted on this application is true and
complete.
Applicant’s Signature
Date
For Office Use Only
Good Standing
Updated
Comments
Learning Support
Warning
Probation
Holds
Suspension
Other