Your form has been saved as a draft. If you need to stop working on this form and continue it later, you may find the form in the pending / drafts section under "My Forms"
Close Window
For security reasons, your session will end in two minutes. Please save your work to avoid timeout.

Re-Admit Form


Timertimer
* = required field

 Re-Admit Form

* * *
Date you last attended CLC (month/year):   
Please enter your current name here:
* * *
Please enter your former name here:
        
   *

Street Address:

*
* * * *
     
E-mail Address:   
* *
     
* *
   *
     
     
Educational Intent:
*
*
*
  * Denotes program offered on the Staples campus.
** Denotes program offered on both the Staples & Brainerd campus.
* I certify that all information provided on this form is complete, accurate, and true to the best of my knowledge.  I understand that misrepresentation of application information is sufficient grounds for canceling re-enrollment.