Office of the Registrar
Returning Veteran
Notification of Re-enrollment


1. Current Academic Status:
    Returning Veteran

2. Social Security Number:    - -

3. Date of Birth:    Month:     Day:     4-digit Year:

4. Full Legal Name:
    Last                                      First                               Middle

5. E-Mail Address:

6. Phone: ( ) -

7. Current Address:    

   Entry Term: Spring 2015    Summer I 2015     Summer II 2015    Fall 2015

9. Last Enrollment:
   Term: Fall    Spring     Summer I    Summer II

10. Current Desired Major:

11. Has your residency (In-State vs. Out-of-State) changed since prior enrollment?

12. High School:
       City:      State:

13. Are you currently enrolled in college coursework at another institution?

By submitting this form, I certify that this information is complete and correct to the best of my knowledge. If my application is accepted, I agree to abide by the policies, rules and regulations at Texas Tech University (The University). I authorize The University to verify the information I have provided. I further understand that this information will be relied upon by the officials of the university in determining my admission and residence status for tuition purposes and that the submission of false information is grounds for rejection of my application, withdrawal of an offer of acceptance, cancellation of enrollment, and/or other disciplinary action. I also agree to notify The University of any change in the information I have provided on this form.

Date:     / /