Reenrollment form for bachelor degree programs

Date:

Name:
Last: First: Middle:
Maiden/Previous Name:

Address:
Street: City: State:
Zip: County:
State in which you maintain your legal residence:
Telephone: Work:
Email:

Age: Date of birth:
Social Security:
Gender:

Check one box:



If other, please specify country and citizenship status:

Enrollment Information
When do you plan to enroll at St. Catherine University? (please indicate both season and year)



Enrollment Status:



What program do you plan to enroll in?


What is your intended major or area of study?
First Choice:
Second Choice:

What will you be?




Where do you plan to live?


Previous Education Information

List all colleges and professional, hospital and technical schools you have attended since you were last at St. Catherine Unversity, whether or not credits were earned. Please list most recent work first.

First School:
Name of School:
Location:
Dates attended:
Degree, diploma or major:
Total # of credits (indicate sem/qtr):
GPA:

Second School:
Name of School:
Location:
Dates attended:
Degree, diploma or major:
Total # of credits (indicate sem/qtr):
GPA:

Third School:
Name of School:
Location:
Dates attended:
Degree, diploma or major:
Total # of credits (indicate sem/qtr):
GPA:

Your last term of enrollment at St. Catherine University was:


Course Work in Progress

Transfer applicants should list present semester or quarter course work.

Name of School:
Course work for Fall:

Course work for Winter:

Course work for Spring:


Optional Information

The following information is optional and is requested for use on federal and state reports as well as institutional research. Supplying this information is not used in determination of one's eligibility for admission, nor will it be used in any type of discriminatory manner.

How would you describe yourself (check all that apply):
If other, please describe here

Religious preference

Please indicate if you will need special services for any of the following:



If learning disabled, please describe
If other disability, please describe
Would you like to receive information about resources for students who are parents?



To the best of my knowledge, the information given above is true. I understand that misrepresentation of facts on this application will be cause for refusal of admission, cancellation of admission, or suspension from the college. By signing this application, I agree to abide by the policies and regulations of the university.


Date (mm/dd/yyyy)