I am apply for re-admission beginning:



  I plan to be studying:


 Last name: 

 First name: 
Middle name:

Maiden name (if applicable):

Student ID:

Phone number:


 Current address:

Current address valid until (dd/mm/yy):


Permanent address: 


What degree do you already have from Mount Allison?

Graduation date:

If re-admitted, will you require residence accommodation?


Are you returning to candidate for a second undergraduate degree?


If yes, please state degree sought:

Are you returning to candidate for an honours certificate?


 If yes, in what subject?

Are you returning to upgrade your remarks and/or complete additional courses and not as a candidate in any of the above categories?


Please outline your proposed program of studies and indicate whether you have discussed this program with a faculty advisor and/or another faculty member.