Reentry Application for Eagle Gate/Provo/Brookline College

Reentry Application for Eagle Gate/Provo/Brookline College

ATTENTION STUDENTS: Please be advised it may take up to 45 days from your submission date to receive a final decision on your application.

Applications for Unitek College, you may apply using this Link.

Reentry Attempt*

Please choose which attempt this is for this application. If this is your 4th attempt, please contact the campus Program Director/Dean for further guidance.

1st

2nd

3rd

Student Name*

First and Last Name

Address*

Number, Street, and Unit #

Address (Cont'd)*

City, State, Zip Code

Date of Birth (Month/Year)*

Student ID Number

Student Email*

Please provide your personal email address in order to receive notifications regarding your application status.

Student Phone*

Phone

Campus Last Attended*

Select

Desired Campus for Return*

Applications for Unitek College, you may apply using this Link.

Select

Desired Program*

Please select the program you desire to enter.

Select or enter value

Desired Month/Year to Return*

This return date will be used to determine potential return dates and not guaranteed.

Cohort/Shift (Student Request)

Please provide your preferred schedule.

Question #1*

Please explain the reason(s) why you were originally withdrawn from your previous enrollment. This should include details, dates, and factors weighing into your decision to drop from the program.

Question #2*

Please explain how you plan to be successful in future courses/modules. Why should we approve your application for reentry? Please be specific in your response.

Question #3*

Please list the steps you will take to support your decision to reenter to our program. Please be specific in your response.

Acknowledgement*

By typing my name, I am acknowledging the information provided in this submission is accurate to the best of my knowledge.

Additional Comments/Information

Optional

Send me a copy of my responses

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