OFFICE OF THE REGISTRAR
THE UNIVERSITY OF NORTH CAROLINA AT PEMBROKE

READMISSION APPLICATION

Directions: Please complete and click the "Submit" button.

 

Your failure to provide complete, accurate, and truthful information on this application will be grounds to deny or withdraw your admission, or dismiss you after enrollment. Please note there is a $25.00 readmission fee that must be paid prior to processing your application.
Yes   No Have you attended any other academic institutions since you last enrolled at UNCP? If you have, DO NOT complete this application, contact the Office of Admissions.

If you are a Regional Licensure student please contact the Licensure Office.
If you are taking graduate level courses please contact the School of Graduate Studies.
If you have not enrolled elsewhere, please continue below.
 
 

 

Provide the following information.
Last Name First Name Middle Sex  
 

 


If you attended UNC-Pembroke before under a different name please indicate that name here.
Last Name First Name Middle  
 

 
Student ID
no hyphens or spaces
Date of Birth
mmddyyyy
Race
Marital Status
  
 
         
        Notice: Permanent address can NOT be a dormitory type address
What is your preferred mailing address?
Street
City
State
 County Zip  
 
         
What is your permanent street address?
Street City
State
 County Zip  
 
           
What is your local address?
Street City State County Zip  
 
           
Home telephone
Work telephone
   
       
Email address
           

Choose your track of study (required)
 
What will your entry status?
Freshman
Sophomore
Junior
Senior
Enrichment Seeking....
(No Financial Aid)
Audit

Second Four......
Year Degree

Certification/Renewal
When do you plan to return to UNCP?
Fall
Spring
Summer I
Summer II

Tell us in your own words what you have been doing since leaving UNC-Pembroke.

When did you last attend UNC-Pembroke? Month
Year
 
Have you complied with the North Carolina Immunization Law? yes no
 
All students must comply with the North Carolina immunization laws. Returning students that fail to demonstrate compliance will be cancelled from their classes and withdrawn from the university. Please contact UNC-Pembroke's Student Health Services
 
Campus Safety Questions
Your "yes" answer to one or more of the following questions will not necessarily preclude your being admitted. However, your failure to provide complete, accurate, and truthful information will be grounds to deny or withdraw your admission, or to dismiss you after enrollment.
For the purpose of the following six questions, "crime" or "criminal charge" refers to any crime other than a traffic-related misdemeanor or an infraction. You must, however, include alcohol or drug offenses whether or not they are traffic related.
   
  • Have you been convicted of a crime?
 Yes No
  • Have you entered a plea of guilty, a plea of no contest, a plea of nolo contendere, or an Alford plea, or have you received a deferred prosecution or prayer for judgment continued, to a criminal charge?
 Yes No
  • Have you otherwise accepted responsibility for the commission of a crime?
 Yes No
  • Do you have any criminal charges pending against you?
 Yes No
  • Have you ever been expelled, dismissed, suspended, placed on probation, or otherwise subject to any disciplinary sanction by any institution of higher education?
 Yes No
  • If you have ever served in the military, did you receive any type of discharge other than and honorable discharge?

Yes No
Currently serving
Never served

   
If you answered "yes" to any of the six questions above, please explain the circumstances below.
You must promptly notify the Office of the Registrar in writing of any criminal charge, any disposition of a criminal charge, or any school, college, or university disciplinary action against you, or any type of military discharge other than a honorable discharge that occurs at any time after you submit this application. Your failure to do so will be grounds to deny or withdraw your admission, or to dismiss you after enrollment. By signing this application you are granting permission for a criminal background check if deemed necessary.
 
North Carolina Residency
North Carolina law (G.S. 116-143.1) states that in order to determine eligibility for the in-state tuition rate, "Every applicant for admission shall be required to make a statement as to the length of residence." The following information should allow for an accurate determination of residency status. If the total time listed below is less than 12 months, please list additional addresses (and length of residency) on additional sheet. you will be contacted if additional information is needed.
  • Are you a legal resident of North Carolina?
yes
no
  • Has your residency changed since you last attended UNC Pembroke?
yes
no
I UNDERSTAND THAT WITHHOLDING INFORMATION requested in this application or giving false information may make me ineligible for admission to/or continuation at The University of North Carolina at Pembroke. With this in mind, I certify that the statements herein are correct and complete. I understand my failure to provide complete, accurate, and truthful information on this application will be grounds to deny or withdraw my admission, or dismiss me after enrollment.
   

 

Return to Forms | Office of the Registrar