• You must submit the following form to the registrar's office by Dec. 1 to reactivate your admission and applicable scholarship.


Last name:

 First name:

 Middle name:

Mount A student ID:
Permanent address:


Permanent phone number (home):

Alternate phone number:

Academic term originally applied and accepted to:
Fall 20
Academic year you wish to reinstate:
 Fall 20  

Intended degree program:  


Please list any activities/employment/volunteer initiatives you have been involved in during your gap year.


Have you attended any post-secondary institutions during your approved gap year? (If yes, please re-apply to Mount Allison via Approved deferrals are only maintained if the student does not undertake any post-secondary studies.)



The statements contained in this application are true and accurate to the best of my knowledge.