Fillable 05 Re-admit Application Darton College Application for Re-Admission

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05 Re-admit Application Darton College Application for Re-Admission

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RE-ADMISSION
APPLICATION
INFORMATION
APPLICATION FOR RE-ADMISSION
Early Application Is
Strongly Advised.
An Affirmative Action Equal
Opportunity Educational
Institution
The Application for
Re-Admission:
Information
and Instructions
Please type or print
legibly in ink.
Follow the
instructions given below
carefully in order to expedite
the processing of your
application. If you need help,
contact the Office of
Admissions at (229) 430-
6740 or toll-free at 1-866-
775-1214.
Return the
completed application to:
The Registrar’s Office
Darton College
2400 Gillionville Road
Albany, Georgia 31707
General Deadlines:
Applications and all
required supporting
credentials must be received
by the Registrar’s Office
before an application can be
evaluated.
General
Information
Legal Residency
To qualify as a legal
resident of Georgia, the
applicant, if over 18 years of
age, must have lived in
Georgia for at least one year
prior to the registration date.
If the applicant is
under 18 years of age, his
parents or legal guardian
must have physically resided
in Georgia for
at least one year (12 months)
preceding the registration
date.
Please note that this
brief explanation of the
residency regulations does
not encompass all the rules
on residency. If in doubt
about legal residence status,
consult the Darton College
catalog for the “Legal
Resident” rules and
regulations of the Board of
Regents of the University
System of Georgia, or
contact the Registrar’s
Office.
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APPLICATION FOR
RE-ADMISSION
A. Re-Admission Information (Please Print or Type Clearly)
This information is required in considering the applicant’s request for admission.
Name
Mr.
Ms.
Miss __________________________________________________________________________________
Last First Middle
Social Security Number _______________________________________ Telephone Number ( _______ ) _______________________________
Mailing Address _________________________________________________________________________________________________________
Street and Number
______________________________________________________________________________________________________________________
City State Zip
Marital Status
Married
Single
Separated
Divorced
Widowed
Term Last Attended __________________________________________ Major at that Time ___________________________________________
Term You Plan to Return ______________________________________ Current Major ______________________________________________
Are any of your records under a different name?
Yes
No If so, what name _____________________________________________
Have you attended any other college since your last enrollment at Darton?
Yes
No
If so, give the names of all colleges attended and the dates of attendance.
______________________________________________________________________________________________________________________
Name of College City/State Dates of Attendance Degree
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
If you have attended another college since your last enrollment, are you applying as a
Transfer
Transient
Auditor
Irregular/Non-Degree
Anticipated enrollment pattern
Day Classes Only
Evening Classes Only
Combination of Day &-Evening Classes
Based on the residency definition in the current catalog, what is your residency classification?
Resident of Georgia. County of Residency _________________________________________
Non-resident of Georgia. State of Residency ___________________________________________
Non-resident of Georgia. Military or military dependent. State of Residency ___________________________________________
I understand that falsification of any statement above constitutes fraudulent enrollment and may result in loss of all credits.
Signature _______________________________________________________________ Date __________________________________________
APPLICATION FOR RE-ADMISSION
FOR OFFICE USE ONLY
Information Received
By Phone
By Letter
In Person
Primary Campus
Main
Cordele
On-Line Only
Thomasville
E-mail Address
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05 Re-admit Application Darton College Application for Re-Admission

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Completed 1 December 2019

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