Undergraduate Request for Readmission

Contact Information

First Name

Last Name

Please list any previous names held, including maiden name.

If your name has changed since your prior enrollment at Radford University, please submit marriage, divorce, or court order paperwork along with a copy of your current photo identification in order for us to update your records. You may mail or fax appropriate documents the Office of the Registrar.

Legal Name Change Documentation

Student ID

Email Address

Mobile Phone Number

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Academic Information

Intended Readmit Term

Students who left the university in good academic standing (i.e., whose cumulative grade point average at Radford University is 2.0 or higher) can apply for readmission not earlier than 6 months before and no later than five days prior to the beginning of the term in which re-enrollment is desired.

Students who left the university in poor academic standing (i.e., whose cumulative grade point average at Radford University is below a 2.0) can apply for readmission not earlier than 6 months before and no later than 30 days prior to the beginning of the term in which re-enrollment is desired.

Intended Campus

Note: the online RN-to-BSN program is available only for students who currently hold or are in programs leading to licensure as a Registered Nurse.

Intended Application Term

Intended Start

Do you plan to change your major if readmitted to the University?

Yes

No

Intended Major

If you are seeking to complete a program in Social Work, Criminal Justice, or Interdisciplinary Studies-Elementary Education K-5 would you be interested in attending the Roanoke Higher Education Center campus?

Intended Major

Major(s) during your previous enrollment

Reason for requesting readmission:

Are you licensed as a Registered Nurse (RN)?*

Yes

No

Have you received, or are you pursuing a program that leads to licensure as a Registered Nurse (RN)?*

Yes

No

Have you taken the NCLEX-RN?*

Yes

No

Date you plan to sit for the NCLEX-RN exam. *

RN License Number*

What state/province issued your license?*

When does your license expire?*

Has your license ever been revoked?*

Yes

No

When was your license revoked?*

Please provide an explanation as to why your license was revoked.*

Have you attended or are you current attending any other colleges or universities since your prior enrollment at Radford?

Yes

No

Please list other colleges or universities attended since your Radford enrollment below.

You must have official final transcripts from each school sent to the Radford University Registrar's Office and all transcripts must be received before your application is reviewed by the Committee.

Failure to disclose all institutions attended will result in immediate cancellation of readmission and registration.

College Name 1

Start Date

End Date

Add Another School

Yes

No

College Name 2

Start Date

End Date

Add Another School

Yes

No

College Name 3

Start Date

End Date

Disciplinary Information

Are you or have you ever been subject to academic suspension or probation at Radford University/Radford University Carilion or any other college or university?

Please use the space in the next section to provide a complete and concise explanation regarding your academic suspension. Please include details or changes to support the expectation that your academic performance will improve if you are readmitted to RU as well as any extenuating circumstances that influenced your prior performance.

Have you ever been found responsible for a violation of the Standards of Student Conduct/Honor Pledge that resulted in your not being considered in good standing, as defined by the Standards of Student Conduct? Examples include, but are not limited to: being sanctioned to probation, deferred suspension, suspension, or dismissal from RU/RUC or any other college or university. Please note it is imperative you disclose any conduct records resulting in any sanctions, even if your case is now considered to be closed. Students must also resolve all pending conduct cases prior to any holds being removed.

Please use the space below to address Standards of Student Conduct violation(s). You must provide a complete and concise explanation including the dates of the occurrence. Your application will not be processed if this section is not completed. Note that non-disclosure or falsification of conduct offenses will result in automatic denial of readmission.

Have you ever been convicted or are you currently being charged with a criminal offense other than minor traffic violations? This includes any case taken under advisement. Non-Disclosure or falsification of these offenses will result in automatic denial of readmission.

Please use the space below you to provide a complete and concise explanation on your criminal offence charge and, if applicable, conviction. Include the date and location of the occurrence.

Disclosures

Honor System:
Radford University operates under an Honor System which provides the foundation for a college community in which freedom, trust and respect can prevail. Upon accepting admission to Radford University, you would agree to make a commitment to support and uphold the Honor System without compromise or exception. By indicating below, I acknowledge my responsibility for knowledge of and compliance with all conditions set forth in the Standards of Student Conduct. I do hereby resolve to uphold the Honor Code of Radford University by refraining from lying, from the illegal appropriation of property, and from violating the Standards of Student Conduct and standards of Academic Integrity. By signing my name below, I have read and understand the above Honor Code statement of Radford University. If offered readmission, I agree to abide by the Honor Code and the rules and regulations of the University.

Discrimination:

Radford University does not discriminate in the administration of its educational programs, activities, admission or employment practices. Inquiries should be directed to the Human Resources Office at (540) 831-5421 or (540) 831-5128 TTY. My signature below indicates that I have read and understand this policy.

Campus Safety:
The University is committed to assisting all members of the Radford University community in providing for their own safety and security. Information regarding campus security and personal safety, including topics such as alerts, crime prevention and crime statistics for the most recent three-year period, can be found at www.radford.edu/police. My signature below indicates that I have read and understand this statement.

Reminder:
This form contains questions regarding Radford University and any other college or university attended as well as any criminal and/or disciplinary actions. Concealment of attendance at another institution since your last enrollment at Radford or any falsification of information on this application, whether intentional or accidental, could result in the cancellation of your readmission and termination of your enrollment.

By typing my full name below, I certify that I have read, understood and agree to all the above-listed conditions and that all information supplied in my application is correct to the best of my knowledge.

Please type your full name to serve as a digital signature.