Trine Student ID (if known)
Former Name (if applicable)
Last 4 digits of SSN
Date of Birth
Prior Attendance Information
Last term Attended
Reason For Leaving
Please briefly list the academic and employment experiences that you have had since leaving Trine.
Along with the form, you should also submit a 3-4 paragraph paper explaining the reasons for your current academic situation, and describe the steps you plan to take that will ensure success in your desired program of study.
Which campus are you applying for readmission?
Each student’s situation is carefully evaluated, and readmission is not guaranteed.
International students must send a copy of their current I-20 and current financial guarantee to the Office of International Services.
Return Attendance Information
Expected Returning term
If readmitted, do you plan to live in on-campus housing?
In order to successfully add your comment you need to click the 'Add Comment' button and ALSO click the 'Save Changes' button at the top of this form.
Reason(s) for leaving