Registrar: Dismissal Appeal Registrar: Dismissal Appeal Students must submit this form by January 8th for spring 2025 readmission.Personal InformationLast Name * Required First Name * Required SUNY Poly ID Number (U#) * Required Email * Required Street Address * Required City, State, Zip Code * Required Telephone * Required Do you plan to live on campus in the residence halls if approved to return to SUNY Poly? * Required Yes No Academic InformationDegree Level * Required Undergraduate Graduate What Academic Program (Major) Are You Requesting Readmission to? * Required Last Term Attended (Term and Year, e.g., "Fall 2022") * Required Have you attended another college/university since you last attended SUNY Poly? * Required Yes No If you have attended another college/university, what is the name of that institution? (You will need to submit an official transcript.) Judicial InformationHave you ever been dismissed from another college/university for disciplinary reasons? * Required Yes No To be considered for possible readmission to SUNY Polytechnic Institute, you must explain what factors led to your academic dismissal AND what factors will be different next semesterIn your own words, please describe the factors that led to your academic dismissal: * RequiredYour specific plan to improve is: * RequiredAffirmation of Identity * Required I affirm that I am the student listed on this form. CAPTCHA
