Worsham College Re-Enrollment Application Step 1 of 3 33% Name(Required) First Last Maiden Name Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone(Required)Email(Required) When did you last attend Worsham?(Required) MM slash DD slash YYYY Select the desired term you would like restart Spring Semester Summer Semester Fall Semester Please indicate if you were withdrawn from Worsham College for any of the following reasons. Academic Integrity Academic Performance Leave of Absence Personal Reasons Other I have read the policies in the Student Handbook, including the Academic Integrity Policy. It is my responsibility to complete and submit all assignments on time and my grade(s) is based on an assessment of my understanding of the concepts in this program. I am responsible for any tuition and fees that may result from my re-enrollment in the program. Tuition and fees may not be covered by financial aid for returning students. I will be enrolled in the next available semester based on course offerings and pertaining to my progress in the program. I must demonstrate satisfactory academic progress in accordance with the Satisfactory Academic Progress Policy. I acknowledge that my program requirements will be based on the most current college policies. Terms of Re-enrollment(Required) I agree Re-enrollment Administrative Fee(Required) Price: Total Credit Card(Required)Card Details Cardholder Name
