Fillable ReadmissionForm OfficeoftheRegistrar/StudentRecords 300N.BeatySt.,AthensAL35611 registrar@athens.edu (Athens State University)

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ReadmissionForm OfficeoftheRegistrar/StudentRecords 300N.BeatySt.,AthensAL35611 registrar@athens.edu (Athens State University)

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ReadmissionForm

(RevisedNov.2020)



OfficeoftheRegistrar/StudentRecords

300N.BeatySt.,AthensAL35611

 Fax:256‐233‐8163Phone256‐233‐8131

 registrar@athens.edu

AthensStateUniversity,asanequalopportunity/affirmativeactioninstitution,complieswithallapplicablefederalandstatelawsregardingnondiscriminationandaffirmativeaction.

AthensStateUniversitydoesnotdiscriminateonthebasisofrace,color,nationalorigin,age,maritalstatus,gender,genderidentity,genderexpression,pregnancy,sexualorientation,

disability,religion,geneticinformation,

orveteranstatusinemployment,oradmissionstoorparticipationineducationalprogramsandactivities.Inquiriesorconcernsmaybe

addressedtotheOfficeoftheVicePresidentforFinancialAffairs,300N.BeatySt.,Athens,AL35611,256‐216‐3303.



SemesterofReadmission:  Year:StudentID(ifknown):



Last4digitsSocialSecurityNumber:DateofBirth:



LastName:FirstName:MiddleName:  



FormerName(s)whenpreviouslyenrolled:



CurrentStreetAddress(Street,City,State,Zip):



CurrentMailingAddress(ifdifferentthanabove):



AlabamaResidentforthepast12months? Yes No



CurrentPhone:HomeWorkCell



CurrentEmailAddress:



Dates/Semestersoflastattendance(approx.ifnotknown):



EnrollingasAdultDegreeProgramstudent? Yes No



PreviouslyEnrolledas:  Degree‐Seeking Certificate‐Seeking  Non‐Degree‐Seeking



Studentswillbere‐admittedunderthesameseeking‐status/programaspreviouslyenrolledifitisstilloffered.TheRegistrar’sOfficewill

contactyouviatheemailsuppliedaboveiftheprogramisnolongeravailable.Oncereadmitted,degree‐seekingstudentswillbeableto

submitaChangeofProgramthroughtheirAthensStateOnlineaccounttochangetheirdegree/major,ortochangefromdegree‐seekingto

certificateornon‐degreeseeking.PLEASENOTETHATFINANCIALAIDISGENERALLYONLYAVAILABLETODEGREE‐SEEKINGSTUDENTS.



ListallinstitutionsattendedduringyourabsencefromAthensState(officialtranscriptsfromeachmustbesenttoAthens

StateOfficeofAdmissions)











Ifyouattendedotherinstitutionsduringyourabsence,wereyouplacedondisciplinary/academicprobationorsuspensionat

anyinstitution? Yes  No



Ifyes,provideabriefexplanation,thedatesofprobation/suspension,whenprobation/suspensionwill/didend.











Signature(required)Date

Thisformisdesignedtobecompletedonacomputer.Pleaseprint,sign,submittotheOfficeoftheRegistrarviaemail,fax,orinperson.

ThisformmustbecompletedandsubmittedtotheOfficeoftheRegistrarbyanystudentwhoisreturningto theUniversityafteranabsence

oftwoconsecutivesemesters(notincludingtheSummersemester).

PleaseNote:StudentsreturningtotheUniversitywho:

 previouslycompletedadegreeorcertificateprogramatAthensStateandarereturningtopursueanewdegree/program,OR

 werepreviouslyadmittedandenrolledascertificateornon‐degreeseekingandnowwishtobecomedegree‐seeking

mustcompleteaNewStudentapplicationandmeetadmissionrequirementsfor

thenewdegreegoal/program.

Fall

2021

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ReadmissionForm OfficeoftheRegistrarStudentRecords 300N.BeatySt.,AthensAL35611 registrar@athens.edu (Athens State University)

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