Please type or print clearly. Be sure to read the instructions at the bottom of this page before completing this application.
When do you wish to reenter? ___ Fall Semester or ___ Spring Semester or ___Summer Semester
of the Year _____

---------------------------------------------------------------------------------------------------------------------------------------
APPLICANT INFORMATION
Name _______________________________________________________________________
Social Security Number ______________________________________
Street Address ___________________________________________________________________________
City ___________________________________ State _____ Zip _____________________
Home Phone ___________________________ Work Phone ________________________
Citizenship Status * (Check One):
___ U.S. Citizen by Birth (C)
___ U.S. CItizen by Naturalization (N)
___ Non-Resident Alien (A)
___ Resident Alien (R)
(Present Alien Registration Card to Admissions for verification, if not already on file)
Country of Citizenship (if not USA) _____________________________________________
Visa Type, if not U.S. citizen ________________________________________________

Sex *
___ Male
___ Female

* Southern Polytechnic State University is required to report data on race/ethnic group/sex/marital status to certain federal agencies as those data relate to civil rights compliance.

---------------------------------------------------------------------------------------------------------------------------------------
ENROLLMENT INFORMATION
First attended Southern Polytechnic State University ______________________________
Last attended Southern Polytechnic State University ______________________________
Name(s) of any colleges currently attending or attended since you were last enrolled at Southern Polytechnic State University. Please have official transcript forwarded to Southern Polytechnic State University for possible Transfer Credit. Transcripts MUST be mailed directly to admissions from sending institution. Use additional sheet if necessary.
Name of School _____________________________ Attended from ____________ to ____________
Name of School _____________________________ Attended from ____________ to ____________
Name of School _____________________________ Attended from ____________ to ____________
Do you hold a degree? ___ Yes or ___ No
From Which Institution? _______________________________________________________
High School Attended? ______________________________________________________
High School Graduation Date (Year Only) ___________

---------------------------------------------------------------------------------------------------------------------------------------
RESIDENCE INFORMATION
Are you a legal resident of Georgia? ___ Yes or ___ No
How long have you continuously resided in Georgia? From ____________ to __________
Where do you pay property taxes? _______________________________
Where are you registered to vote? ________________________________
Where you a legal resident of Georgia when you last attended Southern Polytechnic State University? ___ Yes or ___ No
Where is you automobile registered? _______________________________
Lastest motor vehicle driver's license issued from which state? ____________________

---------------------------------------------------------------------------------------------------------------------------------------
EMPLOYMENT HISTORY
Name of Firm ___________________________________ Employeed from ___________ to ____________
Name of Firm ___________________________________ Employeed from ___________ to ____________
Name of Firm ___________________________________ Employeed from ___________ to ____________
Have you filed a Georgia Individual Tax Return as a resident of Georgia? ___ Yes or ___ No
If yes, last year filed? _______________

---------------------------------------------------------------------------------------------------------------------------------------
Any omission or misrepresentation of facts or failure to furnish the correct information to the Admissions Office will automatically invalidate the readmission of any student.

Signature of Applicant ______________________________________ Date ________________

---------------------------------------------------------------------------------------------------------------------------------------
OFFICE USE ONLY
Recieved ___________________
Demograph _________________
Georgia Resident ____________
Letter Mailed ________________
Academic Standing ___________
Trans-Semester ______________

---------------------------------------------------------------------------------------------------------------------------------------

2. Previous Audit Students must:
a. complete a Former Graduate Student Application to Audit again.
b. complete an Admission Application to be fully admittedd to take courses for credit. Applicants will be required to meet Southern Polytechnic State University admission requirements.

3. Previous Transient Students must:
a. request another transient permission letter from the Registrar's Office at your home institution for each semester you plan to attend
b. complete an Admission Application to be fully admitted. Appliations are required to meet Southern Polytechnic State University requirements.

4. Students who are on academic dismissal must file a Petition for Reinstatement to the Faculty, in addition to completing a Former Graduate Student Application. The signature of your major department is required.

5. If you wish to enroll in a major different from that of your last attendence, you must file a Change of Major form. This form requires the signature of the proposed Department Head.

6. All students must have a complete transcript on file from all schools attended since their last attendence at Southern Polytechnic State University. Transcripts must be sent directly from each institution.

7. If your name has changed since last enrolled, please submit documentation.

*** PLEASE NOTE: Students who are unable to register for the semester for which they are accepted for reentry will need to contact the Re-Admissions Office to be UPDATED to a future semester. Readmitted students must meed graduation requirements under the current catalog.

Mail Former Graduate Student Application to:
Southern Polytechnic State University
Re-Admissions Office
1100 South Marietta Parkway
Marietta, GA 30060-2896

Former Graduate Student Application Deadline Dates
Fall Semester: July 1
Spring Semester: November 1
Summer Semester: April 1