Change of Semester Request - Graduate

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Office of Recruitment & Admissions
800 GSW State University Drive
Americus, GA 31709-4379
admissions@gsw.edu

Change of Semester - Graduate

This form is to be used if you have applied to Georgia Southwestern within the last three years but did not attend classes.

If you have attended classes at GSW, complete a re-admittance form through the Registrar's Office.

Student Information

First Name:

Last Name:

GSW ID (or date of birth):

Address:

City:

State:

Zip (*If you are an international student, please enter '00000'):

Phone Number:

Email:

Last semester applied for:

Intended Major:

All schools attended since last applied (if applicable):

Campus Attending:

Re-applying as a:

Please move my file to the following semester:

Please move my file to the following year:

Georgia Southwestern is committed to maintaining a safe campus environment while providing students from all backgrounds the opportunity to pursue a college education. Prior misconduct, criminal history, etc. are reviewed and may require an applicant to provide additional information; however, applicants are infrequently rejected due to these issues, and we strongly encourage those applicants to apply. Applicants providing an affirmative response to any question may be contacted to provide additional information. Applicants are strongly encouraged to complete their application process.

Have you ever been convicted of any criminal offense other than a traffic violation?

Have you ever been suspended from another college or university?

Are you applying for In-state Tuition?

Have you established and maintained legal residence in Georgia for at least 12 consecutive months immediately preceeding the first day of classes for the term in which you plan to enroll?

If you are under the age of 24, has a parent(s) or US Court-appointed legal guardian established and maintained legal residence and domicile in Georgia for at least 12 consecutive months immediately preceding the first day of classes for the term in which you plan to enroll?

What is your Georgia county of residence?

Have you ever lived outside the state of Georgia?

Have you graduated or will you graduate from a Georgia high school?

Did you (or your parents if you are claimed as a dependant) file a state income tax return this past year?

In which state did you file?

Are you currently a member of the Georgia National Guard or a family
member of someone who is a member of the Georgia National Guard?

I understand that any material false statement made knowingly and willfully by me on this application, or any documents attached hereto may, in accordance with O.C.G.A. 16-10-71, which provides that upon conviction, a person who knowingly commits the offense of false swearing shall be punished by a fine of not more than $1,000 or by imprisonment for not less than one nor more than five years, or both, subject me to prosecution in a court of law. Additionally, I further understand than any such false statement may subject me to immediate dismissal from the institution.

Further, I certify that, to the best of my knowledge, the information submitted on this application is true and complete.

I understand.

All personal data and special categories of sensitive personal data collected or processed by Georgia Southwestern State University must comply with the University System of Georgia’s (USG) Cybersecurity Plan, as authorized by the Board of Regents Policy Manual Section 10.4 Cybersecurity: www.usg.edu/policies. Anyone suspecting their sensitive personal data has been exposed to unauthorized access, report your suspicion to techsupp@gsw.edu. Otherwise, questions concerning general data privacy can be sent to dataprivacy@gsw.edu. Signature (below) and submission of this form provides consent to and acknowledgement of the USG Data Privacy and Legal Notice and relative policies.

As required by Title IX, Georgia Southwestern State University does not discriminate on the basis of sex in any of its education programs or activities, including in admissions and employment. Inquiries concerning application of Title IX can be directed to GSW’s Title IX Coordinator or to the U.S. Department of Education, Office of Civil Rights. Please visit gsw.edu/TitleIX for more information.

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