Continuing Education Undergrad Readmission Application

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Please note: Information entered into the form fields below will not be saved until the form is submitted. If you refresh your screen before submitting the completed form, all previously entered information will be deleted.

All fields marked with an * are required.

If you completed coursework at another institution after you last attended CU Boulder, we recommend that you have an unofficial transcript from the other institution available for uploading as you complete this application.

First Name*

Preferred First Name

Middle Name

Last Name*

Previous names that might appear on your transcripts or credentials

Email Address*

Student ID Number

Phone Number

Mailing Address*

Country

Street

City

Region

Postal Code

Birthdate*

Gender

US Armed Forces Status*
If you have no current or past affiliation with the US Armed Forces, please select "No relationship".

What is your country of citizenship?*

Are you a U.S. Permanent Resident?*

Yes

Alien Registration Number

Alien Registration Issue Date

Country of birth*

City of birth*

Will you be returning to CU on a valid visa? (Note: If you will be completing your degree from outside the United States, please select "No" and choose the visa type "99" below. If you are unsure of your visa or immigration status, please select "No" and choose the "OTH" visa type below.)

Yes

Specify the visa type you currently have or expect to obtain following the instructions below.

If you already have a US Visa, complete all fields below.
If you are completing CU online coursework from overseas, please choose "99 - Intl Student Not In US" as your visa type and leave the remaining fields blank.
If you are unsure of your visa type or immigration status, please choose "OTH - Other" as your visa type and leave the remaining fields blank.

Visa Type

Issue Date

Expiration Date

Please select the college, school or program you are returning to. To see a list of programs and majors, visit the campus academics website.*

Please select the major you will be completing*

Select the term you wish to start*

Have you attended any other colleges since your last attendance at CU Boulder?*

Yes

Name of School (Start typing the name of your school to pull up a list, then find your school on that list. If you cannot locate your school on the suggested list, please indicate this below):

CEEB

Level of Study

Were you able to find your school in the list above?

Yes

Please enter the name of your school here:

Enter your other school's city, state, country (if not USA), and postal code:

Dates you attended this school

From:

To:

Please upload an unofficial scanned copy or digital facsimile of your transcript from this institution. If possible, the transcript you upload should show both your name and the name of the institution. If you are unable to upload your transcript here, you may email it to cerecords@colorado.edu.

Your application for readmission will not be reviewed until all transcripts have been received.

Do you need to add another school?

Yes

Name of School (Start typing the name of your school to pull up a list, then find your school on that list. If you cannot locate your school on the suggested list, please indicate this below):

CEEB

Level of Study

Were you able to find your school in the list above?

Yes

Please enter the name of your school here:

Enter your other school's city, state, country (if not USA), and postal code:

Dates you attended this school

From:

To:

Do you need to add another school?

Yes

Name of School (Start typing the name of your school to pull up a list, then find your school on that list. If you cannot locate your school on the suggested list, please indicate this below):

CEEB

Level of Study

Were you able to find your school in the list above?

Yes

Please enter the name of your school here:

Enter your other school's city, state, country (if not USA), and postal code:

Dates you attended this school

From:

To:

Tuition Classification

Tuition classification is governed by Colorado state law (CO Revised Statutes §23-7-101, et.seq.) and applies to all public institutions of higher education in Colorado. In-state tuition classification eligibility requires one year of Colorado domicile (legal residence). Exceptions to the domicile requirement are provided for specific populations as provided by law. Refer to the tuition classification website for further information about domicile exceptions and Colorado resident/nonresident regulations and requirements.

Do you believe you may qualify for in-state tuition?*

Yes

Will you be at least 23 years old by the first day of the term in which you are enrolling for classes?*

Yes, I will be at least 23 years old by the first day of the term.

No, I will not be at least 23 years old by the first day of the term.

Did you earn a Colorado high school equivalency or graduate from a Colorado high school?*

Yes

No, my high school diploma or equivalency was earned outside of Colorado

Do you have a Colorado driver's license or official Colorado state ID?*

Yes

Have you lived continuously (remained physically present) in Colorado for the past two years?*

Yes

Have you filed resident personal income taxes in Colorado for at least the past two consecutive years?*

Yes

Are you a U.S. citizen, U.S. permanent resident, or undocumented/DACA applicant?*

Yes

Dates of continuous physical presence in Colorado:

From:*

To:*

Dates of absence from Colorado of more than 30 days within the past year, if applicable:

From:

To:

Please describe the circumstances of any such absence.

Dates of employment in Colorado:

From:*

To:*

List the years for which personal resident Colorado income tax returns were filed:*

Are you registered to vote in the United States?*

Yes

State of Voter Registration*

Date of voter registration*

Have you operated a motor vehicle in the past two years in Colorado?*

Yes

Do you own, or have available for personal use, a motor vehicle?*

Yes

State of Vehicle Registration*

Date of current Colorado motor vehicle registration*

Is this a renewal of a previously issued vehicle registration?*

Yes

Do you have a current driver's license or state-issued ID?*

Yes

State of Driver's License*

Date of issue*

If Colorado, list driver's license or ID number*

Is this a renewal of a previously issued Colorado driver's license or ID?*

Yes

Do you own residential property in Colorado that is your primary residence?*

Yes

Date purchased*

Do you maintain a home in another state?*

Yes

Have you ever served in the United States military?*

Yes

List dates of service:

From:*

To:*

Dates stationed in Colorado, if any:

From:

To:

Have you paid in-state tuition in a state other than Colorado by claiming residence in that state during the past two years?*

Yes

If yes, list colleges at which you paid in-state tuition:

Provide any additional information regarding unusual circumstances you would like to have considered.

Did you enter a Colorado college or university immediately after completing high school (e.g. you graduated in May/June and enrolled at a Colorado institution in August of the same year)?*

Yes

Have you lived continuously (remained physically present) in Colorado and maintained a Colorado I.D. since you completed high school?*

Yes

Did you attend a Colorado high school for at least three complete years?*

Yes

Did you graduate from a Colorado public or private high school?*

Yes

Are you a U.S. citizen, U.S. permanent resident, or undocumented/DACA applicant?*

Yes

Because you will not be 23 by the first day of class of the term for which you are applying, you must provide parent or guardian information below. Your residency will be based upon your parent's domicile (residency).

Possible exceptions include emancipated minors, military, married applicants, etc. If you are under 23 and hope to qualify for in-state tuition classification based on your personal domicile, please see the Tuition Classification website to determine whether you should fill out the below information using your own information.

Name of parent/guardian:*

Dates of parental/guardian continuous physical presence in Colorado:

From:*

To:*

Dates of parental/guardian absences from Colorado of more than 30 days within the past year, if applicable:

From:

To:

Please describe the circumstances of any such absence.

Dates of parental/guardian employment in Colorado:

From:*

To:*

List the years for which parent/guardian personal resident Colorado income tax returns were filed:*

Is your parent/guardian registered to vote in the United States?*

Yes

State of parent/guardian voter registration:*

Date of parent/guardian voter registration:*

Has your parent/guardian operated a motor vehicle in the past two years in Colorado?*

Yes

Does your parent/guardian own, or have available for their personal use, a motor vehicle?*

Yes

State in which vehicle is registered:*

Date of current motor vehicle registration:*

Is this a renewal of a previously issued vehicle registration?*

Yes

Does your parent/guardian have a current driver's license or state-issued ID?*

Yes

State of Issue:*

Date of issue:*

If Colorado, list driver's license or ID number:*

Is this a renewal of a previously issued Colorado driver's license or ID?*

Yes

Does your parent/guardian own residential property in Colorado that is your primary residence?*

Yes

Date purchased:*

Address, if different from your permanent address:

Country

Street

City

Region

Postal Code

Does your parent/guardian maintain a home in another state?*

Yes

Has your parent/guardian ever served in the United States military?*

Yes

If so, list dates of service:

From:*

To:*

Dates stationed in Colorado, if any:

From:

To:

Has your parent/guardian paid in-state tuition for you in a state other than Colorado by claiming residence in that state for you during the past two years?*

Yes

If yes, please list institutions:*

Provide any additional information regarding unusual circumstances you would like to have considered.

Disciplinary History

Are you currently under any pending investigations, facing allegations OR been found responsible for a disciplinary violation at any post-secondary institution you have attended for stalking, sexual assault and/or domestic violence?*

Yes

Are you currently under any pending investigations, facing allegations, OR been found responsible for an academic dishonesty violation, such as plagiarism or cheating, at any educational institution you have attended from the 9th grade (or the international equivalent) forward? You only need to report findings of responsibility for academic misconduct if your educational record reflects that you were assigned probation, suspension, removal, dismissal and/or expulsion from the institution. Do not report academic probation and/or suspension due to a low GPA.*

Yes

Have you been found responsible for a disciplinary violation at any post-secondary educational institution you have attended for behavioral misconduct that resulted in a disciplinary action including probation, suspension, removal, dismissal and/or expulsion from the institution?*

Yes

Detailed explanation of incident(s) and outcome (Required)

Please give the approximate date(s) of each incident and your age at the time of the incident, explain the circumstances and reflect on what you learned from the experience. Failure to provide detailed information may delay the processing of your application.

If your school has any documentation concerning your disciplinary incident(s), please upload it here.

Criminal History

You must answer 'yes' to these questions if the conviction was for any type (e.g. simple or aggravated), degree (e.g. first, second, or third), and regardless of whether it was a misdemeanor or felony, enhancement or stand-alone convictions, and where the prosecuting jurisdiction is/was located. You are not required to answer 'yes' to these questions if the criminal adjudication or conviction has been expunged, sealed, annulled, destroyed, erased or otherwise required by law or ordered by a court to be kept confidential. You as the applicant are responsible for providing accurate and thoroughly responsive disclosures to CU Boulder. Failure to do so will jeopardize your admission. Please visit our conduct review page for more information about what crimes should be disclosed, why this information is required, and how it is used in the admission process.

1. Do you have any pending criminal charges?*

Yes

2. Have you been adjudicated guilty or convicted of assault, kidnapping, voluntary manslaughter or murder within five years of submitting your application for admission?*

Yes

3. Have you ever been adjudicated guilty or convicted of stalking, sexual assault and/or domestic violence?*

Yes

4. Are you currently required to register as a sex offender?

Yes

5. Do you have any pending charges OR have you ever been adjudicated guilty or convicted of a misdemeanor or felony?*

If you have been adjudicated guilty or convicted of a DUI, DWAI or other charge related to driving a vehicle under the influence of alcohol or drugs in the past calendar year or have been adjudicated guilty or convicted of more than one DUI, DWAI or other charge related to driving a vehicle under the influence of alcohol or drugs, you must answer "yes" to this question and report these instances.

Note: you are not required to answer "yes" to this question if the criminal adjudication or conviction solely involved the personal use of alcohol or marijuana or has been expunged, sealed, annulled, destroyed, erased or otherwise required by law or ordered by a court to be kept confidential.

Yes

All applicants who answer 'yes' to the criminal history question will go through an additional review once it is determined that the application is academically eligible for admission. This review process may include a background check and some applicants may be asked to provide agency of records which include arrest reports and related court documents. If desired, you may upload these documents below to expedite the review process. More information about the admission procedures for applicants with criminal history can be found on our website.

Arrest reports and court records upload

Social Security Number (required - please enter with no dashes)*

Aliases. Include all previous names, dates the names were used, reasons (i.e. prior marriage, maiden name, etc.)

Marital status*

Date of marriage*

Date of divorce*

Driver's license number

List all states in which you have lived. If you are not yet in the US, please enter "NA." *

Are you currently on parole or probation?*

Yes

Please provide the name, agency, address, email address, and phone number of your parole or probation officer.

Name*

Agency*

Agency Address*

Country

Street

City

Region

Postal Code

Agency Email Address*

Agency Phone Number*

Please enter the length of your parole or probation.*

Please enter the terms of your parole or probation.*

Are you currently in a community corrections program or a resident of a halfway house?*

Yes

Provide the name, address, and phone number of the facility and your supervisor's name and email address.

Facility name*

Facility phone number*

Facility address*

Country

Street

City

Region

Postal Code

Supervisor name*

Supervisor email address*

List all law enforcement infractions. Detail any additional infractions in the text box provided below.

Incident 1 (All fields required for Incident 1)

Date of incident*

Arresting law enforcement agency (i.e. name of police department or other arresting agency)*

Case Number*

Offense Charged*

Court disposition and sentence (i.e. plea agreement, time in custody, probation terms, etc.)*

Incident 2

Date of incident

Arresting law enforcement agency (i.e. name of police department or other arresting agency)

Case number

Offense Charged

Court disposition and sentence (i.e. plea agreement, time in custody, probation terms, etc.)

Incident 3

Date of incident

Arresting law enforcement agency (i.e. name of police department or other arresting agency)

Case number

Offense Charged

Court disposition and sentence (i.e. plea agreement, time in custody, probation terms, etc.)

Incident 4

Date of incident

Arresting law enforcement agency (i.e. name of police department or other arresting agency)

Case number

Offense Charged

Court disposition and sentence (i.e. plea agreement, time in custody, probation terms, etc.)

Additional incidents if applicable. Be sure to include dates, arresting law enforcement agencies, case numbers, offenses charged, and court dispositions and sentences for each additional incident.

Provide a detailed explanation of the incident(s) and outcome. Include information about what you have done since the incident, treatment you have undergone, lessons learned, etc.*

(Required)

Sign the statement and Authorization for Release of Information below:

By typing my name below, I hereby certify that to the best of my knowledge, the information furnished above is accurate, true and complete. I understand that if it found to be otherwise, it is sufficient cause for refusal, dismissal, or discipline. I authorize representatives of the University of Colorado Boulder to make any and all appropriate inquiries regarding the information listed in this supplement, including conducting a criminal history background check through a third party provider.

I hereby release the university, its officers, employees, and representatives from any liability or damage that may result from furnishing the information requested or conducting the background check.

Applicant signature*

Date*

By submitting your registration form, you certify that to the best of your knowledge, the information submitted in this form is true and complete. You understand that if found to be otherwise, it is sufficient cause for refusal or dismissal. You also agree to all terms and conditions as discussed in this form.

In place of your signature, please type your full legal name and then hit enter:*

Signature = 1