Penn State's Home Page Office of the Registrar's Home Page
Undergraduate Reinstatement 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 $35.00 non-refundable reinstatement fee will be required to complete this application.


Student Name:
PSU ID:      OR     SSN:
Last Year Enrolled:
Permanent Residence:  (Confirmation letter will be sent to this address.)
Street 1:
Street 2:
City/State/Zip:
Phone Number:
ex: 800-234-5678 or (800) 234-5678
 

Since you last enrolled at Penn State, have you attended another college or university?
No Yes
If you answered Yes, please arrange for an official transcript to be sent to the
Undergraduate Admissions Office
 

Since you last enrolled at Penn State, have you been dismissed/suspended for disciplinary reasons from any other institution?
No Yes
 

Since you last enrolled at Penn State, have you pled guilty or no contest, participated in a presentencing diversion program and/or been convicted of a criminal offense, or are there criminal charges pending against you at this time?
No Yes
 
Reinstatement Request:
View Degree/Major Information
Semester/Year
to re-enroll:   
College:
Major:
Option:
Degree:
Campus Location:
Email:
I agree to allow Penn State to use this email address to communicate with me about my reinstatement request.


Revised: 11/05/2013