Reinstatement Request Form

Please use this form to request reinstatement to an unfinished program at Moravian University. As you have already been accepted to your program at Moravian, you do not need to apply again and will not need to pay an application fee.

We recommend that you begin this process no later than 30 days prior to the start of the term for which you wish to return.

You will need to pay any outstanding balance from your past attendance at Moravian prior to being reinstated.

First Name

Last Name

Former Name

Birthdate

Moravian Student ID (not required)

Email Address

Please use an email account that you are actively monitoring as most communication regarding your reinstatement request will be via this email address.

Mobile Phone

Can Moravian University text you on your mobile phone?

YesNo

Current Street Address

Current City

Current State

Current Zip

When did you last attend Moravian

For which semester would you like to return to Moravian?

Have you attended any colleges or universities while you were away from Moravian University?

YesNo

Please list each college or university that you attended while away from Moravian University. You will need provide a copy of each transcript to provost@moravian.edu.

Are you returning to finish your graduate or undergraduate degree at Moravian?

Are you interested in living on campus when you return to Moravian?

To which undergraduate program would you like to return?

If you are considering more than one program from the list below, please select the program that most meets your needs. You will be able to discuss your options and which program is right for you once your request for reinstatement is submitted.

Are you interested in living on campus when you return to Moravian?

Yes, Moravian does offer housing for graduate students, too!

To which graduate academic area would you like to return?

Have you ever been found responsible for a disciplinary violation at any secondary or post-secondary school you have attended, whether related to academic misconduct or behavioral misconduct, that resulted in your probation, suspension, removal, dismissal, or expulsion from the institution?

YesNo

If yes, please list the approximate date of each incident and the circumstances. Please also reflect on what you learned from the experience. (approx. 100-250 words)

Have you ever been adjudicated guilty or convicted of a misdemeanor or felony? Note that you are not required to answer "yes" to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise required by law or ordered by a court to be kept confidential.

YesNo

Please provide the details of your criminal conviction or adjudication and reflect on what you learned from the experience. (approx. 100-250 words)

Do you have pending charges, been found responsible for, or been subject to discipline for violating a high school, college or university policy through a Title IX or sexual misconduct proceeding?

YesNo

If yes, please list the approximate date of each incident and the circumstances.

Have you ever been criminally convicted for sexual violence, interpersonal violence or any other act of violence?

YesNo

If yes, please list the approximate date of each incident and the circumstances.

Variable