Skip Navigation LinksHome > Admissions Office > Readmission Interest Form

Readmission Interest Form

Have you previously been accepted and studied at Clinton? Have you stopped attending Clinton for at least one academic semester? Learn more about our simple readmission process to prepare to register and return to Clinton Community College. Let's Get Started:

First Name: *

Last Name: *

Former Name

PO Box or Street Address: *

City: *

State: *

Zip: *

Phone Number: (XXX)-XXX-XXXX *

Cell Phone Number *

Email: *

Last four digits of students Social Security Number: *

Since leaving Clinton, have you attended any other college or university? *

If yes, please list the names of any additional colleges attended since leaving Clinton.

In the last semester you attended Clinton, were you academically dismissed?

If yes, have you completed the Academic Appeal process and received permission to return?

Since last attending Clinton, have you been dismissed from another college for disciplinary behavior reasons? *

What degree program do you intend to enroll? *

 I understand I must clear all existing department holds on my student account. Existing holds may delay online registration.

Enrollment Type:
 Full Time (12+ credits per semester)
 Part Time (1-11 credits per semester)

Student Type: *

I wish to return to campus for the... *