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Returning Undergraduate CSC Students

Chadron State College Re-Admit Application

Students who have not been enrolled at CSC for one to five years may use the "Returning CSC Students" form below. Students who have not been enrolled at CSC for more than five years are required to fill out a new application for admission.

Additional Information
First Name:
Middle Name:
Last Name:
Name when you last attended CSC :	If different than above
Current Mailing Address:
City:
State:
Zip:
Phone Number:
Email:
What Major are you interested in?:
Will you be an Online Student or an On Campus Student?:	On Campus Online
Date you last attended CSC:
When do you plan to attend CSC?:
Is this your second Bachelor�s degree?:	Yes No
Have you been suspended from another college since you last attended CSC?:	Yes No
Have you ever been convicted of a crime other than a minor traffic offense?:	Yes No Note: a conviction record is not an automatic bar to admissions. This will be determined on a case-by-case basis.
Colleges/Universities you have attended since CSC
First Institution:
Name of Institution:
Credits Earned:
Date(s) Attended:
Second Institution:
Name of Institution:
Credits Earned:
Date(s) Attended:
Third Institution:
Name of Institution:
Credits Earned:
Date(s) Attended:
Please enter the following code:
By submitting this form, I certify that the information I have provided above is complete and true to the best of my knowledge without evasion or misrepresentation. I understand that if it is later found to be otherwise, it will be sufficient cause for denial or suspension and forfeiture of all fees and deposits.