Undergraduate Readmission Application

Use this undergraduate readmission request form only if you meet all of the following criteria:

You have not attended Youngstown State University for three consecutive semesters.
You are not re-enrolling in the RN to BSN program. Students re-enrolling in the RN to BSN program should contact Undergraduate Admissions.
You have not attended another college or university since last attending YSU. If you have attended another college or university since last attending YSU please complete a former transfer application on the Undergraduate Admissions website.

Personal Information

Last 4 Digits of SSN *

Banner ID number (Y00XXXXXX) *

Name *

First

Middle name(s)

Last

Maiden/Former Name(s)

Permanent Address

Street *

City *

State *

Zip *

County *

Mailing Address (if different from permanent address)

Street

City

State

Zip

County

Email *

Your email address will be used for communicating about this form and readmission status.

Primary Phone *

Date of Birth *

Year

Month

Day

Sex *

Which term do you wish to enter? *

Are you a resident of the State of Ohio? *

Are you a U.S. Citizen? *

How long have you resided at your permanent address? (years/months) *

If you have resided at your permanent address for less than one year, list your previous addresses for the past two years

Street

City

State

Zip

County

If you have resided at your permanent address for less than one year, list your previous addresses for the past two years

Street

City

State

Zip

County

Are you a member or a veteran of the U.S. Armed Services? *

Education goal *

Education goal Other...

Intended major *

Have you ever been charged with or convicted of a felony or misdemeanor crime (excluding a minor misdemeanor or traffic offense)? *

If yes, when?

Please Read and Sign Below

Application cannot be processed without your signature. I certify that to the best of my knowledge the information given in this application is true. I further certify that I have not attended accredited colleges or universities since last attending YSU. I understand that any omission or misrepresentation of facts will be cause for refusal of readmission, cancellation of application, or dismissal from the University if later discovered. I also agree to provide any credentials requested by the Records Office and once the credentials are received they become the property of the University.

Electronic Signature *

The electronic signature consists simply of your name, typed by you on your keyboard. The signature is your confirmation that is your own work and the information is factually true. Once you type in your name, this will count as your electronic signature.

Date *

Year

Month

Day

Leave this field blank

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