Reactivation Form

Before submitting this form, please determine if you are eligible to enroll after open enollment begins (check the Academic Calendar for the first day newly admitted or readmitted students can enroll.). Your reactivation is subject to approval by your former academic department. In order to avoid a possible late enrollment fee, this form must be submitted one month prior to the official first day of classes. The fee is non-refundable so it is suggested that you contact your department prior to submitting the reactivation form.

Please complete all sections of this form

This reactivation is for:

First Name:

 

Last Name:

 

Email address:

 

Address:

 

City:

 

State:

 

Zip:

 

Have you moved in the last 12 months?

Yes No

 

KU ID:

 

Telephone:

 

What is your department/degree that you are requesting for reactivation:

 

Payment Option

Visa
MasterCard

 

Credit Card Number:

 

Security Code:

 

Expiration Date:

 

MonthYear

 

Name on Card:

 

Last modified: Aug 04, 2014
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