Application for Re-Admission

Have you previously been accepted and studied at Clinton? Have you stopped attending Clinton for at least one academic semester? Complete this application to return to Clinton Community College.

Note: This application is for non-Nursing majors. Students who wish to be admitted into the Nursing program should use the main application: Application Management.

Admissions Plan

*Intended Major

*Start Semester

*How do you plan to take courses?

*Are you applying for full-time or part-time study?

Full-time (12+ credits)

Part-time (less than 12 credits)

Student Information

*Clinton Student ID

*First Name

Preferred First

Middle Name

*Last Name

Suffix

Former Name

*Birthdate

Contact Information

*Permanent Address:

Country

Street

City

Region

Postal Code

Home Phone

Mobile Phone

*Email Address

Colleges Attended

*Provide the month and year you last attended Clinton Community College

*Since leaving Clinton, have you attended any other college or university?

Yes

Number of colleges attended since leaving Clinton

Institution #1

*College Name

*Level of Study

*Start Date

*End Date

*Credits/Hours Earned

Graduation Date

Degree Granted

Institution #2

*College Name

*Level of Study

*Start Date

*End Date

*Credits/Hours Earned

Graduation Date

Degree Granted

Institution #3

*College Name

*Level of Study

*Start Date

*End Date

*Credits/Hours Earned

Graduation Date

Degree Granted

Previous History with Clinton Community College

*In the last semester you attended Clinton, did you leave in good standing or were you academically dismissed?

Good standing

Academically Dismissed

*Have you completed the Academic Appeal process and received permission to return?

Yes

*Have you been dismissed from Clinton or any other college for disciplinary reasons (not including academic dismissal)? An affirmative response to this question will not automatically prevent admission, but applicants will be asked to provide additional information.

Yes

*Please give the approximate date(s) of each incident, explain the circumstances and reflect on what you learned from the experience. You may use up to 400 words.

*I understand I must clear all existing department holds on my student account. Existing holds may delay online registration.

I agree