Undergraduate Program Reinstatement

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Complete this form if you have not attended another college since leaving Elmhurst University and have been enrolled at Elmhurst University within the last 5 years.

Attention

THIS FORM IS TO BE COMPLETED IF YOU HAVE ATTENDED ELMHURST UNIVERSITY WITHIN THE LAST 5 YEARS AND HAVE NOT ATTENDED ANY OTHER INSTITUTION SINCE LAST ATTENDING ELMHURST UNIVERSITY.

eNumber / Student ID

E-mail Address

Phone Number

Major

___________________________________________________

When this information is received you will be contacted via the email provided regarding your program status.

WELCOME BACK!

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Your name

Your email address

Verification Code