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1 Enrollment Management Registrar s Office One University Drive Camarillo, CA Phone: (805) APPLICATION FOR RE-ENTRY Students requesting to return to CSU Channel Islands after more than two semesters away (not to include winter or summer) without having a leave of absence on file, are considered re-entry students and will not need to re-apply for admission. Note: Any student who has been academically disqualified will have to go through the formal reinstatement process prior to being readmitted. If you have been disqualified, please visit this page: Deadlines for Submission by term: INSTRUCTIONS: FOR RE-ENTRY IN FALL: July 1 st FOR RE-ENTRY IN SPRING: December 1 st 1. Meet with an Academic Advisor in the Academic Advising Center to review academic requirements. You will need to obtain an advisor s signature on this form. Visit for contact information. 2. If you have completed any coursework since you last attended CSUCI, you must send official transcripts. 3. Complete the required CSU Residence Questionnaire form attached to this application and provide required documentation. For more information on California Residency for CSU Tuition Purposes, visit 4. A decision and/or response will be communicated within 10 business days via . Name Student ID Address Phone Date of Birth Major: You must establish a major by 60 or more baccalaureate units. Impacted majors may not be available at the time of re-entry. I wish to return to CSU Channel Islands (Required): Term Year

2 Which of the following describes the reason why you stopped attending CSU Channel Islands? (check all that apply) Was not eligibile to return because of grades Could not afford to return Decided to take the semester off Struggled to pass classes Transferred to another institution Are you any of the following? (check all that apply) Veteran Military Dependant Not a member of the military Could not get the class(es) that I needed CSUCI did not have the major that I was interested in Personal Reasons (health, family situation, etc.) Other Did you attend any other college/university during your absence from CSUCI? (If yes, fill out the information below) Institution Location Dates of Attendance CERTIFICATION I certify that my statements on this application are true and complete to the best of my knowledge. I acknowledge that eligibility to enroll in courses at CSUCI is contingent upon having paid any fees that are owed and taken care of any account holds. I understand that any misrepresentation of information may be cause for denial or cancellation of admission or enrollment. Student s Signature Date Advisor s Signature Date Administrative Use Only Registrar s Office Processed by PS Update Student Notified Certifying Official Notified Resident Specialist Notified

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