Antioch University Re-enrollment Application
Complete this form to request re-enrollment to Antioch if the following are true:
* You wish to return to the same degree or certificate program that you were enrolled in when you stopped attending and
* You have been gone for less than three years.
If you wish to start a new degree or certificate program, or if you have been gone longer than three years, please contact the Admissions Office of your home campus to review procedures for returning.
First Name *
Your answer
Last Name *
Your answer
If your name has changed since you last attended, please provide your previous first and last name:
Your answer
AU ID# or last four digits of SSN *
Your answer
Address *
Your answer
Email Address (personal or Antioch) *
Your answer
Phone Number *
Your answer
Name of program or credential you wish to continue: *
Your answer
Academic Degree or credential *
Campus to which you wish to return: *
Term requesting to return. (Note: start term may be determined in consultation with program) *
In a few sentences, please briefly describe the factors that caused you to stop attending previously. *
Your answer
In a few sentences, please explain why you wish to be considered for re-enrollment at this time, noting any relevant changes in your situation since you left Antioch and describe your plan to complete your academic program. *
Your answer
Have you attended another college, university, or professional school since you last attended Antioch? *
If yes, please list the institutions attended. Please be aware that you will need to submit an Official Transcript from each institution.
Your answer
I understand that, as a student seeking re-enrollment, my request must be approved by the chair of my academic program, as well as by the Registrar's office, the Student Accounts office, and as relevant, the Financial Aid office, and that re-enrollment is not guaranteed. I understand that I may be required to submit additional materials or schedule an interview. I understand that degree requirements may have changed, and that some of my previous coursework may not meet current requirements. I understand that misrepresentation or omission of information may result in denial of admission. I certify the information in this application is complete and accurate. *
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