Reentry Application for Eagle Gate/Provo/Brookline College

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.

First and Last Name

Number, Street, and Unit #

City, State, Zip Code

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

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

Please select the program you desire to enter.

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

Please provide your preferred schedule.

Please explain the reason(s) why you were originally withdrawn from your previous enrollment.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.

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.

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

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

Optional