I am apply for re-admission beginning:




I plan to be studying:


Contact information

Last name: 

 First name: 
Middle name:

Former surname (if applicable):

Student ID:

Phone number:


 Current address:

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


Permanent address: 

Education information

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?


Are you registered, or do you intend to register, with The Meighen Centre (disability services)?



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