Re-Enrollment Form

Personal Information

First Name

Middle Name

Last Name

Preferred Name

Lynn ID

Email Address

Mobile

Gender

Birthdate

Citizenship

Are you a permanent resident?

Please select the appropriate visa you will require.

Address

Country

Street

City

Region

Postal Code

Academic Information

When did you last attend Lynn University? (mm/yyyy)

Select the division you would like to return to:

When would you like to return:

Which program of study are you returning for?

I plan on taking courses

Have you attended another school since your last semester at Lynn University?

Yes

Please list the school(s) you have attended since your last semester at Lynn.

School Name 1

School Name 2

School Name 3

Have you ever been found responsible for a disciplinary violation whether for academic misconduct of behavioral misconduct at an educational institution since you last attended Lynn University?

Please explain the disciplinary violation.

Do you plan to live on or off campus upon your return to Lynn University?