Readmit Student Application

If you were previously enrolled at UT Martin but had a break in enrollment or graduated, you are a readmission applicant.

Personal Background

Name

Prefix

First (Legal)

Middle

Last

Suffix

Preferred First

Other Last Names Used

Current Address

Mailing Address

Country

Street

City

Region

Postal Code

Permanent Address

Same as Mailing Address

Country

Street

City

Region

Postal Code

Email Address

Current Email

Telephone Numbers

Mobile Phone

Home Phone

Biographical Information

Sex

Birthdate

Are you a resident of Tennessee?

Primary Citizenship

State/Territory of Birth

Country of Birth

Social Security Number (Omit Dashes)

Application Information

What type of application are you completing?

When do you plan to enroll?

Which UT Martin location do you plan to attend?

What are you interested in studying?

If you are interested in pursuing a professional degree in the health field, please select a pathway.

Veteran Information

Veteran/Guard/Reserve Status

Veteran Classification

Are you the child of a Veteran?

Yes

Are you the spouse of a Veteran?

Yes

Final Steps

Have you ever pled guilty or been convicted of a criminal offense or pled no contest to a crime other than a minor traffic violation?

Yes

Please explain the circumstances surrounding your legal standing.

Are you currently on probation or parole?

Yes

In which county and state are you on probation/parole?

Do you have any charges pending?

Yes

Signature

I certify that the information on this application is complete and correct, and I understand that the submission of false information or withholding information is grounds for denial of my application, withdrawal of any offer of acceptance, cancellation of enrollment or any appropriate disciplinary action. I authorize the University to verify the information that I have provided with all the schools I have attended. I agree to notify the proper officials of the institution of any changes in the information provided. I give my high school(s) and/or college(s) permission to release my transcript(s) to the University of Tennessee at Martin.

UT Martin, in compliance with the Clery Act, publishes an Annual Security Report and Annual Fire Safety Report. This report includes statistics of certain crimes that are reported and that occurred on campus in certain off-campus buildings or property owned or controlled by the University or an officially recognized student organization, and on public property within or immediately adjacent to and accessible from the campus for the three most recent calendar years. Also included are campus security policies that cover multiple crime and safety categories. You can view the report online or obtain a paper copy of the report by contacting the Department of Public Safety at 731-881-7777.

UT Martin is committed to protecting the rights of individuals in compliance with the European Union’s General Data Protection Regulation. UT Martin is collecting this personal data in order to consider your application for admission. For further information, please refer to the University's Privacy Notice.

In place of your signature, please type your full legal name: