Undergraduate Education, LC 30Phone: (518) 442-3950

Withdrawal and ReadmissionFax: (518) 442-4959

Petition to the Committee on Academic Standing

for Matriculated UndergraduateStudents

All applicants for readmission are required to pay a $40 non-refundable application fee. Readmission to the University is not guaranteed.Your application will be carefully considered and you will be informed of the decision as soon as ALL materials are received and reviewed.

The Committee on Academic Standing only reviews petitions during the fall and spring semesters.

If you were academically dismissed from the University or if your cumulative grade point average at the time of your withdrawal was less than 2.00, you are required, by University policy, to petition the Committee on Academic Standing for readmission consideration. Please be aware that the Committee does not follow its regular meeting schedule in the summer or winter months; timeliness, therefore, is of particular importance. See below for other documentation you may need to submit.

PLEASE PRINT CLEARLY

Name:______

LastFirstMiddle

Student ID#:______

Address:______

StreetCityStateZip

Phone: (______)______EMail: ______

Applied for Term of Readmission:___Fall___Winter___Spring___Summer Year______

I wish to study on a:___full-time___part-timebasis.

I was:____academically dismissed______TERM

____left the University with less than a 2.00 gpa ______term

1)Briefly describe the circumstances that contributed to your weak academic record and to your failure to meet minimum academic expectations. SUPPORTING DOCUMENTATION OR OTHER SUBSTANTIATION SHOULD BE ATTACHED.If you need more space, please attach additional sheets.

(PLEASE COMPLETE REVERSE SIDE)

2)What have you been doing since you left the University?

3)What steps have you taken to ensure academic success in the future? What changes have occurred that will now allow you to be academically successful?

4)Have any changes occurred on your University at Albany transcript since you were last in attendance (e.g., errors which have been corrected, completion of incompletes, change of grades, etc.)?

5)Have you attended any other college(s) since you were last in attendance here? If so, list the name(s) of all colleges attended and each term, whether or not you expect to receive transfer credits. If you are currently enrolled in coursework that will not be issued a final grade until the end of the term, your appeal will be reviewed in January or June. A final decision will be made after we receive an official transcript showing grades earned for all coursework from each college or university you attended.STRONG GRADES FROM ANOTHER COLLEGE OR UNIVERSITY MAY ENHANCE YOUR CHANCES OF READMISSION; THEY DO NOT GUARANTEE IT.

PLEASE NOTE: Official transcript(s) must be forwarded to this office.

MAKING FALSE STATEMENTS AND/OR FILING FORGED DOCUMENTS AND/OR SUBMITTING FALSE MATERIAL TO A UNIVERSITY COMMITTEE VIOLATES THE STANDARDS OF ACADEMIC INTEGRITY.SUCH VIOLATIONS ARE SUBJECT TO APPROPRIATE DISCIPLINARY ACTION.

______

SignatureDate

No action can be taken on your request for readmission until this form has been received. It should be returned directly to this office.

Updated 3/1/18

Undergraduate Education/Withdrawal and Readmission, Lecture Center 30

University at Albany

Albany, NY 12222

Telephone (518) 4423950Fax (518) 442-4959