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Get Jacksonville University Registrar Form

Jacksonville University Registrar s Office 2800 University Blvd. N. Jacksonville FL 32211 Office 904 256-7090 Fax 904 256-7086 Application for Readmission This form is needed if the student was not enrolled for the most recent fall or spring term. It serves as a notice of interest to reenroll. It should be submitted to the Registrar s Office at least one month before registration for any term so the necessary preparation can be made. Mr. /Miss/Ms. /Mrs. /Other Last First Middle/Maiden Social Security Number JU ID Name s under which you were last enrolled if different from above if your name has changed since you were last enrolled please complete a Name Change Form Date of last enrollment at Jacksonville University When do you plan to reenter Semester / Year Permanent address Number Street City State Zip Permanent telephone Cell if different Daytime telephone Email address Ethnic/Race Survey optional Part 1 Hispanic/Latino end of survey Non Hispanic/Latino go to Part 2 Part 2 American/Alaskan Native Asian Black or African American Hawaiian/Pacific Islander White Has citizenship changed Yes No If so please specify I am reapplying as check one UNDERGRADUATE Traditional Accelerated Degree Program Nursing RN to BSN Transient /Non Degree GRADUATE Business MBA Business Non-degree Choreography MFA Education MA in Mathematics Math Non-Degree Marine Science MA/MS Undergraduates only My intended degree/major is Check and complete either statement I or II as applicable I. I have attended the following colleges or universities since my last enrollment at If you checked the line above please have official transcripts sent to the JU Registrar s Office once all grades have been awarded. II. Mr. /Miss/Ms. /Mrs. /Other Last First Middle/Maiden Social Security Number JU ID Name s under which you were last enrolled if different from above if your name has changed since you were last enrolled please complete a Name Change Form Date of last enrollment at Jacksonville University When do you plan to reenter Semester / Year Permanent address Number Street City State Zip Permanent telephone Cell if different Daytime telephone Email address Ethnic/Race Survey optional Part 1 Hispanic/Latino end of survey Non Hispanic/Latino go to Part 2 Part 2 American/Alaskan Native Asian Black or African American Hawaiian/Pacific Islander White Has citizenship changed Yes No If so please specify I am reapplying as check one UNDERGRADUATE Traditional Accelerated Degree Program Nursing RN to BSN Transient /Non Degree GRADUATE Business MBA Business Non-degree Choreography MFA Education MA in Mathematics Math Non-Degree Marine Science MA/MS Undergraduates only My intended degree/major is Check and complete either statement I or II as applicable I. I have attended the following colleges or universities since my last enrollment at If you checked the line above please have official transcripts sent to the JU Registrar s Office once all grades have been awarded* II. I certify that I have attended no other college or university since last enrolled at Do you plan to apply for VA Educational Benefits Yes No Signature Date Registrar LettersandForms FormsandSigns ApplicationforReadmission UPDATED 9/27/11.

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