Request To Re-Enroll

This form is to be completed by students who were not enrolled during the immediate past semester and who wish to continue in the school and program in which they were last registered. Students whose last enrollment status was visitor, high school visitor, conditional or who were dismissed must use an admission application form. Students who have not been enrolled with Simmons College of Kentucky for a period of more than two academic years must also re-apply through the Office of Admission.

Name*

First Last

Permanent Address*

Street Address Address Line 2 City State ZIP Code

Mailing Address*

Same as previous

Street Address Address Line 2 City State ZIP Code

Phone number*

CELL
HOME

Email*

Enter Email Confirm Email

Okay to text
Okay to email

Term and Year for which request to re-enroll is being made:*

Full-time
Part-time

Last term attended at Simmons College of Kentucky:*

Fall
Spring
Summer

Full-time
Part-time

Last year attended at Simmons College of Kentucky:*

Name under which you were last enrolled at Simmons College of Kentucky:*

First Last

What was your last academic standing at Simmons College of Kentucky?*

Residency (Do you reside in Louisville, Kentucky?):*

Resident
Non-Resident

Major:*

Have you enrolled at another college or university since your last enrollment at Simmons College of Kentucky?*

YES
NO

Please list name of school:*

Were you a visiting student?*

YES
NO

Because you were NOT a visiting student

You must re-apply to Simmons College of Kentucky and submit the $25 application fee. You may complete this online at www.simmonscollegeky.edu or you may request a paper application be sent to you by calling or emailing the Office of Admission at the contact information listed below.

Here is the link to apply

Email

This field is for validation purposes and should be left unchanged.

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Because you were NOT a visiting student