Dismissal Reinstatement Enrollment Form

Questions marked with a * are required

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Academic Dismissal is the end result of a pattern of poor academic performance, after being warned of the necessity of improved performance. In submitting this Dismissal Reinstatement Enrollment Form, you are participating in a pilot change to the University’s Dismissal Policy. Therefore, this Enrollment Form requests your agreement to specific conditions and expectations related to participating in the Dismissal Reinstatement Program.

Deadline to enroll for Spring Reinstatement: Thursday, January 2nd at noon

For additional information, including key dates and deadlines, please review the SSC website: https://studentsuccess.utk.edu/probation-dismissal-appeals/dismissal-reinstatement/.

Contact Information (Please provide your name as it appears in UT records and your UTK e-mail address).

First Name

Last Name

Phone

Email Address

Student ID Number

Example: 000123456

Desired Major

Note - if you plan or are required to switch majors, please provide that information here.