Readmission Interest Form

If you see this don't fill out this input box.

Have you previously been accepted and studied at Clinton? Have you stopped attending Clinton for at least one academic semester? Learn more about our simple readmission process to prepare to register and return to Clinton Community College. Let's Get Started:

First Name: *

Last Name: *

Former Name:

P.O. Box or Street Address: *

City: *

State: *

Zip: *

Phone Number: (XXX) XXX-XXXX *

Email: *

Last four digits of Social Security Number: *

Since leaving Clinton, have you attended any other college or university? *

Yes

If yes, please list the names of any additional colleges attended since leaving Clinton"

In the last semester you attended Clinton, were you academically dismissed?

Yes

If yes, have you completed the Academic Appeal process and received permission to return?

Yes

Since last attending Clinton, have you been dismissed from another college for disciplinary behavior reasons? *

Yes

Into what degree program do you intend to enroll? *

I understand I must clear all existing department holds on my student account. Existing holds may delay online registration. *

I agree

Enrollment Type:

Full Time (12+ credits per semester)

Part Time (1-11 credits per semester)

Unknown

Student Type: *

I wish to return to campus for the: *