Form linked at https://www.clemson.edu/graduate/faculty-staff/forms.html Form GS00—Request for Academic Renewal Rev. 07/2020
CLEMSON UNIVERSITY GRADUATE SCHOOL E-106 Martin Hall Clemson, SC 29634-5713 864.656.5202
Instructions for GS00 Request for Academic Renewal
INSTRUCTIONS FOR STUDENT: You may use this form for academic renewal only if both of the following
conditions apply:
1. you were dismissed from Clemson University due to GPA deficiency, and
2. you have been away from Clemson University for at least one (1) year after your dismissal.
Approval of this form is not a guarantee of admission, but is a guarantee that the program to which you are
applying will
fully review your application for readmission to the Graduate School. Academic Renewal
following dismissal requires a new online application (https://www.applyweb.com/clemsong/index.ftl) after
Form GS00 has been approved.
All of the courses from your previous degree will be assigned a grade of “X” and your readmission GPA will be
“0”. Please provide your Plan for Success (form GSR1) and intended timeline for completion as a part of your
personal statement on the Graduate Application.
INSTRUCTIONS FOR PROGRAM: This form requires the signature and approval of the program coordinator
for the student’s intended program of study. Signing this form only indicates that the program understands
the student’s desire to begin anew in graduate studies. Prior to signing this form, the program coordinator
and stude
nt should discuss the student’s intentions and commitment to graduate study. The student must
submit a new application and supporting
documents.
Return your completed Form GS00 to t
he Graduate School, E-106 Martin Hall.
You may email the completed and signed PDF to
Form linked at https://www.clemson.edu/graduate/faculty-staff/forms.html Form GS00—Request for Academic Renewal Rev. 07/2020
CLEMSON UNIVERSITY GRADUATE SCHOOL E-106 Martin Hall Clemson, SC 29634-5713 864.656.5202
GS00Request for Academic Renewal
STUDENT INFORMATION
Student name:
Last name First name MI
Student XID#: Student email:
Student permanent address:
PREVIOUS PROGRAM DETAILS
Term last enrolled:
Previous program of study:
NEW PROGRAM DETAILS
Effective term for readmission under Academic Renewal:
£
Enrolling in same program
£
Enrolling in different program:
Student signature: Date:
Coordinator of program of intended enrollment (print name):
Program coordinator signature: Date:
ADMINISTRATIVE ACTION (Sign and pass along in numeric order)
£
1. Approve readmission (Graduate School associate dean)
Signature Printed name Date
£
2. Reset compliance GPA (Graduate School)
Signature Printed name Date
£
3. Login and scan to Enrolled Student Services, subject “Academic Renewal” (Graduate School)
Signature Printed name Date
£
4. Place statement on transcript (Enrolled Student Services)
Signature Printed name Date
£
5. Reset Banner GPA (Enrolled Student Services)
Signature Printed name Date
£
6. Scan for file; forward to Admissions (Enrolled Student Services)
Signature Printed name Date
£
7. Remove hold (Graduate Admissions)
Signature Printed name Date
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