Admissions

Readmission Update Form

Readmission Update Form

Section 1: Applicant Information
Page 1 of 1
Introduction

This readmission update form must be completed by former students who are enrolling after an absence of one or more full semesters (excluding summer).

Personal Information
You must provide a valid email address in order to receive important communications from SSCC about your admission status. If you do not have an email address, you can get one at www.gmail.com or www.yahoo.com .
1. 
Email Address (REQUIRED)                          
*Required, Format: x@x.xx
2. 

First Name (as it appears on your Social Security card)

*Required, Maximum characters allowed: 30
3. 
Middle Initial
Maximum characters allowed: 30
4. 

Last Name (as it appears on your Social Security card)

*Required, Maximum characters allowed: 60
5. 

Suffix (if applicable)

6. 
Preferred Name
Maximum characters allowed: 30
7. 
What is your birth name?
Maximum characters allowed: 30
8. 
Date of Birth
*Required, Format: mm/dd/yyyy
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9. 
What is your mobile/cell phone number?
Format: 123-456-7890
10. 

What is your Home Phone Number (if different than mobile/cell)?

Format: 123-456-7890
11. 

By providing my phone number(s) I understand I will receive important College related text messages and TTS (text to speech) messages from Southern State.

*Required
12. 
Social Security Number
*Required, Format: 123-45-6789
13. 
Ethnicity
14. 

Race (select one or more of the following races:)

15. 
Are you a veteran/service member?  If ‘yes’ a copy of your military/service ID must be submitted to the Records Office.
*Required
Mailing Address Information
16. 
Street Address                                                                   
*Required, Maximum characters allowed: 60
17. 
  P.O. Box (if applicable)           
Maximum characters allowed: 60
18. 
City                  
*Required, Maximum characters allowed: 25
19. 
State 
*Required
20. 
Zip Code  
*Required, Format: 12345 OR 12345-6789 OR 123456789 OR A1B 2C3
21. 
County
*Required
22. 
Have you lived in Ohio for the past 12 months?
*Required
23. 
If no, previous state of residence
24. 
Date moved to Ohio
Format: mm/dd/yyyy
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Anticipated Enrollment Information
Note: You must be degree-seeking to be eligible for financial aid.
25. 

Division of Interest

*Required
26. 
Enrollment Status
*Required
27. 

Enrollment Classification

*Required
28. 

Anticipated Enrollment Term 

*Required
29. 

Anticipated Enrollment Year Begin Date

*Required
30. 

Which campus would you like to attend?

*Required
31. 
Program of Interest
*Required
32. 

My Educational Goal is

*Required
Other College Information
33. 
Last College/University Attended
Maximum characters allowed: 120
34. 
Last Attended College/University City
Maximum characters allowed: 25
35. 
Last Attended College/University State
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