Graduate Application for Reinstatement

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Complete this form if you previously matriculated in a graduate program and withdrew from or did not comply with continuous enrollment (registered for coursework) in the program. Submission of this form results in a review by the academic department. Coursework previously completed will be accepted at the discretion of the academic department.

Fredonia ID # (if unknown, leave blank)

First Name *

Last Name *

Email address: *

Street Address *

City *

State *

Zip Code *

Contact phone # *

Degree program enrolled in at time of departure: *

Describe your activity during your separation from Fredonia

I attended another univesity and will forward my transcripts to the Office of the Registrar

Other:

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What semester and year do you plan to return to Fredonia to begin courses?

PLEASE NOTE: the deadline to apply for FALL semester is the 1st of August and for the J-TERM, SPRING and SUMMER semesters is the 1st of December.

Please provide a timeline and statement of intent for the completion of your graduate program *

Submit

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