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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.

First Name:
Middle Name:
Last Name:
Name when you last attended CSC :	If different than above
Current Mailing Address:
City:
State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip:
Phone Number:
Email:
What Major are you interested in?:	Art Art Education BAS-Technical Occupations-ONLINE Biology Biology Education Business (General) Business (General)-ONLINE Business Admin-ONLINE Business Education Business-with options such as Ag Bus, etc. Chemistry Education Communication Arts Criminial Justice Early Childhood Educ Unified Early Childhood Education Earth Science Education Elementary Education Elementary PE English Education Family/Consumer Science Family/Consumer Science Education Health and Physical Educ Health Education Health Sciences History History Education Interdisciplinary Studies Interdisciplinary Studies-ONLINE Legal Studies Library Info Mgmt-ONLINE Library Media K-12 Literature Math Math Education Math-ONLINE Middle School Education Middle/High School PE Mild/Moderate Disabilities K-12 MS/HS Language Arts Educ Muisc Music Educ K-12 Natural Science Educ Non-degree seeking Non-degree seeking-ONLINE Physical Sci Education Physical Sciences Physics Education Psychology Psychology-ONLINE Range Management Social Science Educ Social Work Sports & Rec Mgmt Theatre Theatre Education Undeclared Undeclared-ONLINE Vocal Music K-8
Will you be an Online Student or an On Campus Student?:	On Campus Online
Additional Information
Date you last attended CSC:
When do you plan to attend CSC?:	Summer 2013 Fall 2013 Spring 2014 Summer 2014
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.