Student Reactivation Form

Student Reactivation Form

Please Read Before Completing Form

If you are an undergraduate degree student and you have studied elsewhere since leaving RIC, or it has been 10 years since you first started at RIC, you must re-apply for admission to the college.

Full Name*

First NameLast Name

Name if different when attending RIC

Date of Birth (MM/DD/YYYY)*

Student ID Number

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mailing Address (if different from home)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Preferred Email*

example@example.com

Preferred Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Is this number a:

Cell PhoneWork PhoneHome Phone

Since I last attended RIC:*

I DID NOT enroll at any other college or institutionI enrolled and took classes at another institutionI was never enrolled in a RIC degree program, I just took a class(es) with RIC

I am reactivating as an:*

Undergraduate NON-DEGREE student (just taking a course(s) at RIC)Undergraduate DEGREE student (returning to my previous program)Graduate NON-DEGREE student (taking a graduate level course(s) at RIC)

I would like to reactivate and begin taking classes in the:*

Summer (May–August)Spring (January–May)Early Spring (December–January)Fall (August–December)

Since your last enrollment, have you been adjudicated guilty or convicted of a misdemeanor or felony?*

YesNo