Returning Student Application Form
WHO SUBMITS THIS FORM:
UH Hilo Students who:
- Stopped-out of UH Hilo for one (1) semester and wish to re-enroll
- Graduate this semester and intend to re-enroll next semester
- Are pursuing internships and cooperative education programs off island and wish to re-enroll
All others should complete the UH Hilo Online Application and pay the $50 application fee.
If you have completed a term at another college during the stop-out semester (excluding NSE and Study Abroad), you
will need to apply for admission as a transfer student using either the online application or UH Hilo/System Application
form.
WHEN TO SUBMIT THIS FORM BY:
Fall Semester: July 1 Spring Semester: December 1
(Applications submitted after these dates will be considered for unclassified admission.)
MAIL OR FAX THIS FORM TO:
Admissions Office: University of Hawai`i at Hilo, 200 W. Kawili Street, Hilo, HI 96720-4091
Fax: (808) 932-7459
Signature ____________________________________________________________ Date ___________________
Certification: I certify that the answers and responses provided for all the items on the Returnee Form are true to the best of my knowledge and belief. I
understand that providing incorrect or false information will subject me to the requirements and / or disciplinary measures as provided under the University's
Student Conduct Code. Furthermore, I understand that I may be required to produce certified documents relative to the determination of my residency status
and that the provision of incorrect information regarding my residency declaration will also subject me to the requirements and / or disciplinary measures
provided for in the University's Rules and Regulations Governing the Determination of Residency for Tuition Purposes.
UH ID or UH
Username
Legal Name: Last First MI Birthdate (mm/dd/yyyy)
Current Mailing Address: Street City/Province State/Country Zip Code
Permanent Address: Street City/Province State/Country Zip Code
Until (mm/yy)
email address
Phone Number
INDICATE YOUR STATUS
SEMESTER RE-ENROLLING
/ /
/
( )
Graduate this semester/Re-enroll next semester
Internship or Cooperative Education Program
Stop-out for one (1) semester
Fall Spring
INTENDED MAJOR
Please explain the reason(s) for your leave of absence:
(By entering your name on the line above, you agree that it is the same as your signature.)
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Birthdate (mm/dd/yyyy)
UH ID or UH
Username
//
Birthdate (mm/dd/yyyy)
UH ID or UH
Username
