New MAV Reinstatement Request

1
Please tell us who is completing this form.* This field is required.
Please Select
Please Select
I am the Student
I am the Instructor
I am the Dean
Please select one option
2
Please note if you are requesting reinstatement for several courses you will need to complete one request for each course.* This field is required.
I understand
3
Please share your reason for your reinstatement request.
4
LSC Student Email
(Ex:mav.montgomery@my.lonestar.edu)
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First Name of the Student* This field is required.
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Last Name of the Student* This field is required.
7
MI
8
LSC ID Number* This field is required.
Seven Digit Student Number
9
Year of request.
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Term of request.
Fall
Spring
Summer
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Reason for the transaction
Reinstatement
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(Documentation Required)
CLASS (ex:12345)
SUBJECT (ex: GOVT)
CATALOG (ex: 2305)
SECTION (ex: 4521)
Class Information
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Class Information
CLASS (ex:12345)
Row 0, Column 0
SUBJECT (ex: GOVT)
Row 0, Column 1
CATALOG (ex: 2305)
Row 0, Column 2
SECTION (ex: 4521)
Row 0, Column 3
13
If you are unsure of your professor's email, please use our Contact Directory to search for their email.
14
Instructor's Email* This field is required.
(Ex:mav.montgomery@my.lonestar.edu)
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Please speak to your professor and let them know you have completed this request. This makes them aware of your request and prompts them to look for the email in their inbox.

The Dean's approval for reinstatement is required. Your professor will forward this form to the Dean for review.
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Please confirm your understanding of the above statements.
I understand
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Student Signature
Clear
18
Date
Date
Month
Day
Year
19
Do you have any additional questions?
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Large
Normal
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Ok
Ok
Should be Empty: