IUGR Re-Entry Application Form

This is an application to reenter the University. Please do not file this form if you attended the University only as a nonmatriculating student or as a graduate student. In those cases, an undergraduate application must be filed.

About You

Family / Last Name

Given / First Name

Your name must match your passport information exactly. Print your names exactly as they appear or will appear in your passport.

Date of Birth

Sex

Female

Male

UB Person Number

Email Address

Are you currently enrolled at UB?

Yes

This application is for students who are no longer enrolled at UB and need to re-enter. Please contact the Office of International Student Services if you have questions about leaving UB.

DeleteSchool Information _ID_
School Information
Name of College/University Are you currently enrolled at this school? Are you currently enrolled at this school? Yes No Level of Study Start Date Start Date End Date End Date Please upload a copy of your most recent transcript from this school

Add Another School Attended

Have you been dismissed, expelled, and/or suspended from a college or university for disciplinary reasons?

Yes

Was this disciplinary action at UB?

Yes

What school did this disciplinary action occur at?

Please describe the action leading to disciplinary action. What was the outcome?

I certify that the statements made on this application are complete and correct; and I understand that falsification of this application will be grounds for its denial or, if I am accepted, for dismissal from the University at Buffalo.