Penn State Office of the University Registrar
Undergraduate Re-enrollment Form

Please fill out this online form, print (using "Print Form" button below), sign and return
the form to the Registrar's Office of the campus at which you plan to enroll.

A $20.00 non-refundable re-enrollment fee will be required to complete this application.

*Only enter your SSN if you do not provide your PSU ID number.
Permanent Residence:  (Confirmation letter will be sent to this address.)

ex: 800-234-5678 or (800) 234-5678

Since you last enrolled at Penn State, have you attended another college or university?
If you answered Yes, please arrange for an official transcript to:
Undergraduate Admissions Office, 201 Shields Building, University Park, PA 16802

Have you ever been dismissed or suspended for disciplinary reasons from secondary school, Penn State, or any other institution, OR are you ineligible to return to a prior institution due to a dsciplinary matter?

Is there an unresolved or pending disciplinary matter at a prior institution?

Have you ever pled guilty or no contest to, participated in a presentencing diversion program for, and/or been convicted of a criminal offense, OR are there criminal charges pending against you at this time?
Re-enrollment Request:

Revised: 02/17/2016