readmission request form

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READMISSION
REQUEST FORM
1201 Social & Behavioral Sciences Gateway
Phone: (949) 824-6803 | Fax: (949) 824-2492 | Email: [email protected]
 Site: http://undergraduatestudies.ss.uci.edu/ugs_usa
Submit this form with your readmission request (i.e. letter, transcript(s)) as noted on the Readmission Policy:
http://undergraduatestudies.ss.uci.edu/files/undergraduatestudies/docs/2010/SocSciReadmissionPolicies.pdf
Name (First, Last):
UCI ID#:
Phone (xxx) xxx-xxx:
E-mail:
Address:
Major (when last at UCI):
Today’s Date (mm/dd/yyyy):
New major (please note that there is no such major as “General Social Science”)
1st Choice:
2nd Choice (CANNOT be any Econ or Psych):
Quarter last attended UCI:
Fall
Winter
Spring
Quarter requesting readmission:
Summer Year:
Fall
Winter
Spring
Summer Year:
List all colleges/universities attend since leaving UCI:
List all School of Social Sciences classes taken AFTER leaving UCI with a grade of “C” or better:
Course
School:
Grade:
Revised: 10.05.12
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