Re-Entry Application

Personal Information

*First Name

*Middle Name

*Last Name

Former Last Name (If Applicable)

*Student ID Number (w1xxxxxx or w3xxxxxx)
If unsure, please leave blank

*Birthdate

*Have you and/or a parent or spouse served in the U.S. military? Check all that apply.

Self

Parent/Spouse

Neither

Application Information

Last Date of Attendance

*Desired Entry Term

*Desired Major
If you are pursuing a degree program, please choose your intended major. If you are not pursuing a degree program and wish to be a non-degree seeking student, please choose "Non-Degree."

*Applicant Statement
Please let us know your plans upon re-entry (Complete a degree, take a course, audit classes, etc.)

Contact Information

*Permanent Home Address

Country

Street

City

Region

Postal Code

*Mailing Address

Country

Street

City

Region

Postal Code

*Email Address

*Cell Phone Number

Academic Information

List all institutions of higher education attended since leaving UW-River Falls.

Students must have one official transcript from all colleges listed sent to the Registrar's Office. Your re-entry application will not be processed until all transcripts have been received. Please have the transcripts sent to the following address: Admissions Office, 410 S 3rd St, River Falls, WI 54022. Transcripts not mailed directly from your previous institution will not be accepted. Falsification of records or failure to file transcripts will result in the cancellation of current registration.

Name of Institution #1

Name of Institution #2

Name of Institution #3

Name of Institution #4

Name of Institution #5

Residency Information

*Length of Time at Current Address

to

Please list any other previous addresses in the past two years:

*Do you live in Wisconsin?

Yes

No

I have lived continuously and only in Wisconsin since:

*Check all that apply:

I have filed Wisconsin state income tax returns as a resident for the past two years.

I recently moved to Wisconsin for full-time employment and intend to maintain a permanent home in Wisconsin.

I graduated from a Wisconsin high school AND my parents have resided in Wisconsin for at least 12 months or did so at the time of their deaths.

None of the above.

Has your citizenship changed since your last enrollment?

Yes

No

Has your visa status changed since your last enrollment?

Yes

No

Certification of Accuracy

I certify that this information is complete and accurate to the best of my knowledge.

Digital Signature (Type Your Full Name)

Date

2022 Re-Entry App

Previous UW-River Falls Student Looking to Continue Education

Application Type

Re-entry

Application Submitted Flag

Yes

Application Round Always Create

Yes

Application Submitted Date

Re-Entry Application

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