North Carolina A&T State University Registrar

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Academics

Admissions

Undergraduate Readmission Application

Undergraduate Readmission Application Form

Effective July 1, 2011 all applicants are required to pay a $35 non-refundable fee. Applications will not be processed until the fee is paid. Check, money order, credit card, and debit card are the only forms of payments accepted. Cash will not be accepted. Please make checks and money orders out to North Carolina A&T State University.

Please fill out the form completely. Write N/A where applicable.
For security purposes, the identity of your computer will be recorded.

Date Of Birth:

Gender: MaleFemale

Email Address:

Full Legal Name:


Last	First	Middle	Maiden

Name while you were an A&T Student:


Last	First	Middle	Maiden

Permanent Home Address:


Street	City	State	Zip

Local Address (if different):


Street	City	State	Zip

Telephone Number:


Permanent	Billing	Local

Are you applying for on campus housing?

YesNo

Semester you plan to return:

Year:

What semester and year did you first attend A&T?

What semester and year did you last attend A&T?

10.

Are you seeking a second degree?

YesNo

If so, please answer the questions below.

	Where did you obtain your first degree?
	What was your date of graduation?
	What is your intended major?

11.

Are you returning for undergraduate certification?

Yes No

12.

Have you attended any other school(s) than A&T?

YesNo

If you have attended other colleges/universities, have a transcript mailed to the address below.

North Carolina A&T State University, Admissions Office, 1601 East Market Street, Greensboro, NC 27411

13.

Race:

If you are a foreign student, please enter your country of citizenship below.

Your "yes" answer to one or more of the following questions listed below will not necessarily preclude your being admitted. However, your failure to provide complete, accurate and truthful information will be grounds to deny or withdraw your readmission, or dismiss you after enrollment.

	14.	Have you been convicted of a crime (other than a minor traffic violation)? Yes No
	15.	Have you entered a plea of guilty, a plea of no contest, a plea of nolo contedere, or an Alford plea, or have you received a deferred prosecution or prayer for judgment continued, to a criminal charge? Yes No
	16.	Have you otherwise accepted responsibility for the commission of a crime? Yes No
	17.	Do you have any criminal charges pending against you? Yes No
	18	Have you ever been expelled, dismissed, suspended, placed on probation, or otherwise subject to any disciplinary sanction by any school, college, or university? Yes No
	19.	Do you currently serve in the military? Yes No
	20.	Have you ever served in the military? Yes No If you have ever served in the military, did you receive any type of discharge other than an honorable discharge? Yes No

If you answered "yes" to any of the questions above, please explain the circumstances. You must notify the Registrar's Office in writing of any criminal charge, any disposition of a criminal charge, or any school, college, or university disciplinary action against you, or any type of military discharge other than an honorable discharge that occurs at any time after you submit this application. Your failure to do so will be grounds to deny or withdraw our readmission, or dismiss you after readmission.

Certification

I hereby affirm that by submitting this form, all information supplied on this form is complete and accurate. I understand that withholding information requested or giving false information may make me ineligible for readmission.