Request To Re-Enroll

Semester for which request to re-enroll is being made:

Fall
Spring
Summer

Year for which request to re-enroll is being made: (Required)

Last Name (Required)

First Name (Required)

Student ID

Your E-Mail Address (Required)

Current Telephone Number (Required)

Enter number without dashes

Last Attended U of L: (Select 0ne) (Required)

Fall
Spring
Summer

Last Year Attended: (Required)

Career

Undergraduate
Graduate

Last School at the University: (Required)

What is your major? (Required)

Name under which you were last enrolled: (Required)

Date of Birth: (Required)

/ /

What was your classification for fee purposes when last enrolled at U of L? (Required)

(If Non-Resident desiring change, complete Residency Petition Form)

Resident
Non-Resident
Reciprocity

Have you been a resident of another state since your last enrollment at U of L? (Required)

(You will be classified as a non-resident pending review of the Residency Petition by the University Residency Office, Houchens Building Room 130)

No
Yes

What was your academic status at the end of your last semester of college enrollment? (Required)

Have you enrolled at another college since your last enrollment at U of L? (Required)

(If Yes, complete lines A & B below)

No
Yes

A) Name of School

B) Did you enroll there as a visiting student?

(If no, and you are an undergraduate student, you must re-apply through the Office of Admissions.)

No
Yes

Please read this statement and confirm that you accept the following conditions by entering your name in the space below: (Required)

I understand that I am to be allowed to register provisionally based upon my assertion that the above information is accurate and true; and that should such information not be valid, my registration will be canceled. Fees will be based on a tentative residency evaluation and will be subject to change.

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Request to Re-Enroll

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