University of Northern Iowa
APPLICATION FOR READMISSION
(START YOUR ANSWERS ON THIS FORM. IF YOU NEED ADDITIONAL SPACE, YOU MAY USE THE REVERSE SIDE OR ATTACH SHEETS AS NECESSARY.)

Name                                                                      
            Last                    First                Middle

Student Number                           
 

Address                                                                   
                            Street

Today's Date                                
 

                                                                                
        City                            State               Zip

 Phone No.                                    
 

Readmission desired for                       Semester                      Year

The completed application and all supporting documents must be received at least SEVEN CALENDAR DAYS PRIOR to the beginning of the above term.
1. Occupations or jobs since last enrollment at UNI:
Dates: Occupations: Employer: Address:
 
 
2. Schools or colleges attended since last enrollment at UNI (provide transcript copy):
Dates: School/College: Address: Degree:
 
 
3. If readmitted, program would be: ___ Teaching ___ Non-teaching ___ Undecided
       Major would be: ________________________________ ___ Undecided
4. Why do you feel that this is an appropriate program and major for you?
 
 
5. Outline your academic goals and immediate plans to reach those goals once readmission is granted.
     List specific courses that you plan to complete in your next registration.
 
6. With whom have you had recent contact regarding your educational goals and academic problems?
       A) Major or proposed major department _____________________, no contact ___.
       B) Other academic advising services _______________________, no contact ___.
7. Why do you feel that you will do a better academic job than you did before? What evidence can you present in support of your belief that you will do so (To say that you will study more is not an adequate answer.) Be specific.
 
 
8. Do you plan to be employed while attending the University? ___
    How many hours of employment a week? _______
    Employer: ___________________________________
    How many credit hours of university course work do you plan to carry? ____________________
9. What were the causes of your previously deficient academic performance? How have these factors been reduced or eliminated?
 
 
 
10. I wish to schedule a personal meeting with the Committee on Admission and Retention to discuss
my application for readmission. Yes ___ No ___. I understand that if I wish make a personal appearance before the Committee I must make desire known at this time.

It is hereby certified that the information I have provided on this application for readmission, and any additional material I may provide in support of this application is complete, accurate and true. It is understood that misrepresentation, omission of information or failure to provide complete information may cause delay of consideration, or cancellation of the application or registration.

In addition, I understand that my registration is subject to cancellation if I fail to abide by specified restrictions under which I may be readmitted.

                                                              
Date

                                                                                          
Signature
NOTICE: this information is requested to facilitate consideration of your application for readmission. All information other than directory information is confidential and will not be released to third parties. All items are required. Therefore incomplete forms may not be processed.