RETURNING Undergraduate STUDENT APPLICATION
Last, First, Middle
City, State Zip
Date of Birth:
Campus Wide ID:
Gender: Male Female
Check ‘ ’ the Term you plan to re-enroll at Mines, and insert the corresponding Year next to the term.
Summer Session One:
Summer Session Two:
Are you seeking another undergraduate degree from Mines?
If yes, prior Mines graduation date:
Dates of previous attendance
Class standing when last attended: Sr Jr Soph Fr Degree/Major Option:
Have you ever been on suspension from Mines?
Are/were you required to see the Readmission’s Committee before registering again at Mines?
I hereby affirm all the information supplied on this form is true to the best of my knowledge.
Please email back to email@example.com or mail to:
Colorado School of Mines, Admissions Office, 1600 Maple Street, Golden, CO 80401
Toll free: 1-888-446-9489 Fax: 303-273-3509 303-273-3220 www.mines.edu