Former student supplementary questionnaire form

Please note

If you are on academic suspension or dismissal, please complete this supplementary questionnaire to accompany your application for re-admission.
Please submit a $20 application fee with your application and complete this questionnaire by March 1 for admission to the spring/summer term, by June 1 for admission to the fall term, and by Nov. 1 for admission to the winter term.
Payment must be received by the Registrar's Office prior to processing. This payment can be made by cash, debit, cheque, money order, or VISA/Mastercard. Cash/debit payments can be made at the Registrar's Office on the second floor of the Wallace McCain Student Centre. Cheques can be dropped off at the Registrar's Office or forwarded to the office at 62 York St., Sackville, NB, E4L 1E2.
Your application will not be processed until any outstanding balance is paid.
In reviewing your application for re-admission, the admissions committee will consider your activities since leaving Mount Allison. To provide this information, please answer all questions, limiting your answers to the space provided.

Before you begin to fill in this form, make sure you have:

student ID number
a list of activities (including dates, responsibilities, etc.) undertaken since you left Mount Allison
a list of courses taken since leaving Mount Allison (including course title, institution, and results)

* Indicates required field

Full name *

Student ID *

E-mail address *

Please summarize your activities (including particulars such as dates, responsibilities, etc.) since leaving Mount Allison. *

If you have taken any courses since leaving Mount Allison, please supply the course title, the name of the institution attended or attending, the actual or projected completion date of the course and the results, if available.

Please note that credit cannot be given for courses taken elsewhere during the suspension period. Official transcripts with final grades for courses taken at other institutions must be forwarded directly to the Registrar's Office from the host institution. Any discovery of a failure to report results from courses taken elsewhere could result in cancellation of an offer of re-admission.

Please explain why you feel you were unsuccessful during your previous registration at Mount Allison. *

In light of your past performance at Mount Allison, and your activities since leaving, why do you feel you are ready to resume your course work? *

Finally, is there any information/impression in addition to that provided above that you would like the committee to consider? *

The statements contained in this application are true and accurate to the best of my knowledge. *

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