Readmission or Status Change: Dental, Health Sciences Professional and Law
Purpose: used by former Dental, Health Sciences Professional and Law students to request readmission or are currently enrolled and wish to apply for a Change of Status. In addition
those students that were Required to Withdraw for Academic Reasons (RWAR), have a College Academic Alert (CAA) on their record or failed Satisfactory Academic Progress
(SAP) in their last term at Marquette must also use the Academic Censure/Satisfactory Academic Progress Appeal form for your program.
Student Instructions:
1. Complete Sections 1-3 of this form using a computer.
a. a handwritten form will not be accepted.
b. an incomplete form without the required documents attached will not be processed and returned to you for completion.
2. Section 3 of this form to be completed ONLY by former students seeking readmission.
3. Print the form using the 'Print Form' button.
4. Sign the form in Section 4; a digital signature is not acceptable.
5. Submit the completed form and supporting documents via one of the methods listed at the bottom of this form.
6. Once your application has been processed, the Office of the Registrar will notify you.
Note:
a. Request must be received by the Office of the Registrar no later than one week prior to the start of the term in which you wish to enroll.
b. If you were academically dismissed/censured before leaving the University, the Academic Censure/Satisfactory Academic Progress Appeal form appropriate for your program must also be submitted with this
Readmission form.
Email
enter personal email address if you no longer have an MU email account
Date of Birth
MM/DD/YYYY
@marquette.edu
Academic load (check one)
Full-Time Part-Time
Degree status (check one):
Degree-Seeking
Non-Degree
Law School
Dental School
College / school in which you wish to register
(check one):
Signature Date
Are you currently enrolled?
Yes No
If no, enter year of last attendance:
Rev. 9/2019
In which term do you intend to enroll?
(check all that apply)
Fall
Spring
Summer
Health Sciences Professional: Physician Assistant
Health Sciences Professional: Physical Therapy
Readmission
Status Change (degree to non-degree or vice versa)
Former Name(s)
Section 1: Type of Request (check all that apply)
Section 2: Student Information
Section 3: Former Student Seeking Readmission
NoYes
Have you ever been convicted of a felony?
If yes, please attach an explanation.
NoYes
Are you eligible to return to those institutions?
If no, please attach an explanation.
Other institutions:
NoYes
Have you attended other institutions since you last attended Marquette?
If yes, please list those institutions below.
If yes, enter date of conferral:
NoYes
Have you earned a previous degree from Marquette?
WhiteNative Hawaiian or Other Pacific Islander
Black or African American
Asian
American Indian or Alaska Native
What is your race?
(Check one or more):
No, I am not Hispanic or Latino
Yes, I am Hispanic or Latino
Are you Hispanic or Latino?
(check one):
OtherU.S. Visa HolderU.S. Citizen, Permanent Resident or Immigrant
Check one
Section 4: Student Statement/Signature
I hereby request readmission and/or a status change as indicated above to the college/school and I understand that the college/school into which I request readmission and/or status change has the final decision.
Expected Graduation Term
(Degree-Seeking students only)
Name
Last name, First name, Middle name
Mailing Address
street address, city, state, zip code
Term/Year
Did you receive an RWAR, CAA, or SAP notification in your last semester at Marquette?
If yes, STOP! You are using the wrong form. See Purpose under form title.
Yes No
PhoneSSN/MUID
Hand Deliver: Marquette Central, Zilber Hall, 121, 1250 West Wisconsin Avenue, Milwaukee, WI 53233
Mail: Marquette University, Zilber Hall, 221, P.O. Box 1881, Milwaukee, WI 53201-1881
Email: otrdocs@marquette.edu
No
Term/Year
Yes
Are you requesting to return after a Medical Withdrawal?
If yes, enter the year and term of the Medical Withdrawal.
