COLLEGE READMISSION EVALUATION FORM
Name: ____________________________________________ PID: ___________________________________________
Phone: _______________________________________ E-Mail: ______________________________________________
Submit this completed form and related documentation to your College Academic Advising Office no later tha
n
t
wo weeks before the University’s readmission deadline
.
Students applying to take UCSD Summer Session courses for readmission must submit this form to their College
Advising Office by June 1.
• UCSD Summer Session I: An option only for students who qualify to return no earlier than fall quarter
.
• UCSD Summer Session II: An option only for students appealing to return no earlier than the following
winter or spring quarters. Please indicate below in which summer session you are enrolling.
Check the Virtual Advising Center
for communication from your college regarding the status of your readmission
request.
If your request is approved, you must submit the University’s Readmission Application by the University’s
readmission deadline.
Your signature below acknowledges that you have read the instructions above.
Student’s Signature: _______________________________________ Date: __________________________________
SECTION 1: PERSONAL STATEMENT
Submit a 1-2 page, typed, double spaced statement addressing the following:
a. An explanation of the issues(s) you experienced during the quarters that led to your academic disqualification.
b. A description of the actions you have taken while away from UC San Diego in order to prepare for readmission.
c. A plan of action you intend to follow should you be readmitted, including any support systems and strategies
you will utilize.
Attach a copy of transcripts from all institutions you have attended and/or other supporting documentation.
SECTION 2: ACADEMIC PLAN
a. Meet with your major department/program advisor (your declared major or, if you are changing majors, your
p
roposed major) to develop a realistic plan for the next three quarters.
b. Your major department/program advisor must endorse this plan.
c. Please review your degree audit and include remaining general education and/or University requirements.
Previous Major: __________________________________ Proposed Major: __________________________________
: If enrolling in Summer Session,
indicate Session I or Session II
OFFICIAL USE ONLY: MAJOR ADVISOR ENDORSEMENT
Major Advisor: _____________________________________________________ Date: _____________________________________
Comments: __________________________________________________________________________________________________
OFFICIAL USE ONLY: COLLEGE REVIEW
APPROVED DISAPPROVED Quarter of Return: _____________ Signature/Date _________________________________
Comments: __________________________________________________________________________________________________
