Edison State College
Edison Campus
Student Request For Reinstatement

Student Request for Reinstatement from Academic Suspension or Dismissal:

Home Campus:
Please select a campus.
Your Student ID:
(if known)
Your Full Name:
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Address:
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City:
A value is required.
State:
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Zip:
A value is required.
Phone #:
Edison Email:
(must use Edison email)
@edison.edu A value is required.
Reason for Petition:
Please select an item.Please select a reason.
Current Major / Program:
A value is required.
Anticipated Graduation Date:
(mm/dd/yyyy) A value is required.Invalid format.
Semester to return to Edison: Please select a valid item.Please select an item.
Please enter a short explanation why this petition should be considered:

  characters remaining (at least 50 required) Exceeded maximum number of characters.
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Submittal Terms:

I have read and understand the petition submittal terms.
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Security Code:
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