PLEASE READ AND SIGN:
To the best of my knowledge, the foregoing is correct and complete. Furthermore, as a Harding University student, I agree to abide by all
rules, regulations and requirements of the University, including financial matters. I also agree that any credit balance on my account in the
Business Oce may be applied to other debts to the University. I understand that amounts received from aid awards will be credited to my
school account. If a credit balance results, I authorize Harding University to hold my credit until I make written request for it.
APPLICATION FOR RE-ADMISSION
MALE FEMALE
FULL NAME: LAST NAME, FIRST NAME, MIDDLE INITIAL
PREFERRED NAME MAIDEN NAME
DATE OF BIRTH: MONTH, DAY, YEAR SOCIAL SECURITY
ADDRESS: STREET, RURAL ROUTE, P.O. BOX
CITY STATE ZIP CODE
HOME PHONE CELL PHONE
RELIGIOUS PREFERENCE
MEMBER? YES N
O
WHICH CONGREGATION?
APPLICANT’S SIGNATURE DATE
Harding University does not discriminate on the basis of race, color, creed, religion, sex, marital status, age, disability, national or ethnic origin, or receipt of public
assistance in its educational programs, activities or employment to the extent required by law, except where necessitated by religious tenets held by the institution
and its controlling body.
COMPLETE FORM AND RETURN TO ASSISTANT VICE PRESIDENT/DEAN OF STUDENTS, BOX 12252, SEARCY, AR 72149-5615
OFFICE USE ONLY
YES
NO
£
APPROVED BY
STUDENT LIFE
HOURS
GPA
£
APPROVED BY
BUSINESS OFFICE
STATUS
TRANSCRIPT(S)
ON FILE
£
APPROVED BY
PROVOST
CHECK THE BOX THAT APPLIES:
1. HAVE YOU BEEN INVOLVED IN CASES OF CRIMINAL OFFENSE
OTHER THAN MINOR TRAFFIC VIOLATIONS SINCE YOUR LAST
ENROLLMENT AT HARDING?
YES (PLEASE ATTACH AN EXPLANATION) NO
2. HAVE YOU BEEN SUSPENDED OR DISMISSED FROM AN ACADEMIC
INSTITUTION SINCE YOUR LAST ENROLLMENT AT HARDING FOR
A. DISCIPLINARY REASONS?
YES (PLEASE ATTACH AN EXPLANATION) NO
B. ACADEMIC REASONS?
YES (PLEASE ATTACH AN EXPLANATION) NO
3. MARITAL STATUS:
SINGLE MARRIED SEPARATED
WIDOWED D
IVORCED
YEAR
11. ARE YOU COMPLETING
PREREQUISITES FOR A
DEGREE PROGRAM?
12. PLEASE LIST COLLEGE OR UNIVERSITIES ATTENDED SINCE YOUR LAST
A. NAME OF INSTITUTION
LOCATION: CITY, STATE, ZIP
DATE S AT TEN DED DEGREES OR HOURS COMPLETED
B. NAME OF INSTITUTION
LOCATION: CITY, STATE, ZIP
DATE S AT TEN DED DEGREES OR HOURS COMPLETED
13. DO YOU EXPECT TO RECEIVE FINANCIAL AID? YES NO
14. ALL SINGLE STUDENTS UNDER 22 YEARS OF AGE MUST LIVE IN
UNIVERSITY HOUSING:
I PLAN TO LIVE IN A DORM
I WILL COMMUTE FROM HOME OR LIVE WITH RELATIVES.
WITH WHOM WILL YOU LIVE?
I AM A MARRIED STUDENT AND DESIRE CAMPUS HOUSING
I AM A MARRIED STUDENT AND WILL LIVE OFF CAMPUS
1217
H NUMBER
YES NO
YES NO
7. L
AST ENROLLED AT HARDIN
G
F
ALL
SPRING
S
UMMER
8. DID YOU COMPLETE A DEGREE?
IF SO, WHICH ONE?
9. WHAT SEMESTER DO YOU PLAN TO RETURN TO HARDING?
FALL SPRING SUMMER YEAR
10. ARE YOU SEEKING A DEGREE?
IF SO, WHAT IS YOUR PLANNED MAJOR?
IF SO, WHICH ONE?
YES NO
YES NO
I WILL PROVIDE AN OFFICIAL TRANSCRIPT FROM EACH INSTITUTION. I
UNDERSTAND THAT A HOLD MAY BE PLACED ON MY ACCOUNT IF
TRANSCRIPTS ARE NOT SUBMITTED WITHIN MY FIRST SEMESTER AFTER
READMISSION.
ENROLLMENT AT HARDING. IF MORE SPACE IS NEEDED, ATTACH A
SEPARATE PAGE.
5.
ARE YOU A U.S. CITIZEN?
4. NAME OF SPOUSE
6. MILITARY AFFILIATION
AS OF
£
APPROVED BY
REGISTRAR
H NUMBER
IMMUNIZATIONS
COMPLETE
YES
NO
STATUS
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