Admissions | Intent to Return

HUMPHREYS UNIVERSITY

Intent to Return

This form is for returning students who have previously taken courses at Humphreys.

Student Information

Campus *

Stockton

Modesto

Online

Please provided latest information to update your student records.

First Name *

Last Name *

Last 4 SSN: *

Have you changed your name since you last attended Humphreys? *

Yes

No

To process name change, formal documentation must be submitted, i.e. marriage or driver’s license.

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Have you attended another college or university since last attended HU? *

Yes

No

Official transcripts from other institutions attended must be submitted.

Academic Information

Intended Program/Major *

Intended Degree *

Is this program/degree different from when you last attended HU? *

Yes

No

I understand that intended course of study will be effective and supersede previous course of study and will be under current catalog year requirements . *

I have read and agree to abide by policies stated in the current general catalog. I agree to pay for tuition as indicated in the schedule of tuition and fees and I agree to pay for all services and supplies in accordance. I certify that the information on this application is complete and correct to the best of my knowledge. *

Signature

Student Signature: *

clear

Today's date * +