Registrar: Dismissal Appeal Registrar: Dismissal Appeal Students must submit this form by August 1, 2023 for fall 2023 readmission.Personal InformationLast Name * Required First Name * Required SUNY Poly ID Number (U#) * Required Email * Required Address * Required Telephone * Required Academic InformationDegree Level * Required Undergraduate Graduate What Academic Program Are You Requesting Readmission to? * Required Last Term Attended (Term and Year, e.g., "Fall 2021") * 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
