REQUEST FOR RE-ADMISSION/RE-REGISTRATION
CUK/ASR/FORM17

OFFICE OF THE REGISTRAR (ACADEMIC AFFAIRS)
Email address *
Kindly Indicate your Full Name *
Kindly indicate your registration number
Kindly indicate your campus *
Kindly indicate your programme *
Indicate your year of study *
Indicate your semester of study *
Indicate your Postal Address *
Indicate your phone number *
Indicate your CUK Student Email Address *
Date *
MM
/
DD
/
YYYY
I hereby request (choose the relevant one) *
Specify duration you have been away: *
Reasons for having been away (Tick appropriately) *
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