Request for Readmission

Please use this form if you have been absent from Robert Morris University for four(4) consecutive semesters not including the summer session.

*First:

*MI:

*Last:

*Current Address:

*City:

*State:

*Zip:

*Date of Birth (MM/DD/YYYY):

*Home Phone:

Work Phone:

*Email:

*Citizen Status:

Previous Address:

Previous Name(s):

*Last Semester Attended:

*Term for Readmission:

*Type of degree for readmission:

Answering "yes" to any of the questions below will not automatically disqualify you from being reinstated at RMU. However, the individual circumstances will be evaluated to determine your status. Applicants are expected to immediately notify Robert Morris University should there be any changes to the information requested regarding disciplinary history since your last term of attendance at RMU:

Have you ever had nonacademic disciplinary action taken against you at another institution?

Yes
No

Has disciplinary action ever been taken agaisnt you as the result of a violation at any educational institution you have attended, whether related to academic misconduct or behavioral misconduct? Such action could include but is not limited to probation, suspension, removal, dismissal or expulsion from the institution.

Yes
No

Have you ever been adjudicated guilty or convicted of a midemeanor, felony, or other crime? (you are not required to answer "yes" to this question or provide an explanation if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded or otherwise ordered by a court to be kept confidential.)

Yes
No

*Electronic Signature:

By checking this box, I hereby make my electronic signature. I have read and agree to all of the conditions of the electronic signature.

Conditions of electronic signature:	To the best of my knowledge, all of the information submitted via this form is correct and complete. I am not attempting to gain access to, or modify, another person's account or personal information without their expressed permission. Any misrepresentation may be deemed just cause for any of the following: Collegiate Judicial Hearing Dismissal from the University Legal prosecution

*	Denotes a required field.