Readmission After Voluntary Withdrawal Form | School of Graduate Studies

First Name *

Middle Name

Last Name *

Student ID *0 / 7

Program *

Major *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Email Address *

Phone *

Were you a Veteran/Veteran financial aid eligible while enrolled? *YesNo

Were you an international student while enrolled? *YesNo

Were you contacted by ReUp Education? *YesNo

Are you a United States Citizen? *YesNo

When was the last semester and year you attended UMES? *0 / 11

Were you ever previously placed on disciplinary probation or dismissed from the university for disciplinary or judicial reasons? *YesNo

If yes, please explain why and when. *

Did you withdraw from UMES for health reasons? *YesNo

If yes, please explain. You must contact the University Health Service Department for Medical Clearance *

Were there any extenuating circumstances that occurred that led to you being withdrawn from the university? *YesNo

If yes, please explain *

Did you use/take advantage of any support services such as UMES Counseling during the last semester you were enrolled prior to withdrawing? *YesNo

Did you attend any other college or university since leaving the University of Maryland Eastern Shore? *YesNo

If yes, please list all names of school(s) attended *

Please provide a detailed statement as to why you were not able to be academically successful while enrolled at the university. If there were extenuating circumstances that affected your academic performance, please attach below any supporting documentation (e.g. doctor's notes, hospital records, records of death of immediate family member) electronically to be reviewed by the committee. All extenuating circumstances attributed to illness/medically related must be supported by an appropriate medical professional, in writing, and may be forwarded for review to the university's Health Center. Incomplete applications/applications missing required documentation will not be reviewed, with the dismissal status upheld. *

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By signing this box , I am electronically signing my application. I certify that the information submitted on this application is correct. I agree to abide by the rules, policies and regulations of the University of Maryland Eastern Shore if this application is approved