Graduate Re-Enrollment Application

This application is intended for people who previously enrolled in a graduate program at Western Oregon University but have not taken a graduate course during the past year (4 or more consecutive terms, including summer). If this does not describe you, please complete our graduate application below:

Graduate Program Application

I previously enrolled in a Graduate program at WOU but did not take a graduate course in the past calendar year.

Personal Information

First Name

Middle Name

Last Name

Preferred First Name

Birthdate

Student ID

Social Security Number
(omit dashes)

WOU requires either your student ID V-number or social security number to locate your previous enrollment record. Your social security number is also required in order to be considered for need-based financial assistance and must match the information on your FAFSA.
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Have you lived in Oregon for the past 12 consecutive months?

Yes

When did your present continuous stay in Oregon begin?

Contact Information

Email Address

Cell Phone

Mailing Address

Country

Street

City

Region

Postal Code

Permanent Address

Same as Mailing Address

Country

Street

City

Region

Postal Code

Academic Information

Program

My program name

Re-enrollment term

Are you returning from Leave of Absence?

Yes

DeleteSchool # _ID_
Institution Name Institution CEEB (Hidden) Level of Study GPA Start Date Start Date End Date End Date

Add a school

Signature

Graduate Programs

Graduate Re-Enrollment Application

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