Supplemental Reenrollment Information

First Name

Last Name

9 Digit PSU ID#

Major Seeking Re-enrollment to

instruction

In the text box below please submit a statement requesting re-enrollment that includes: *

Reflection on past goals and performance
Development of realistic goals and plans to achieve these goals
Description of what has been accomplished while away from the University
Description of any extenuating circumstances that caused the academic difficulty and how those circumstances have changed.

Additional document(s) to support your re-enrollment request

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