Update Student Status
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Please read the text below to ensure you are completing the correct form.

This form is for previous undergraduate students who have already attended JSU and earned credit but have not attended within the last year.

Student Information
SSN: JSU Student Number:
Date of Birth:

Full Name
Last:
First:
Middle/
Maiden:

Name Attended Under*
Last:
First:
Middle/
Maiden:
*If your name has changed since you last attended, you must complete the Personal Information Change form provided through the Registrar's Office. This form should be completed and returned with documentation of the name change to the Admissions Office.
Present Mailing Address
Street:
City: State: Zip:

Residence
Please check the appropriate:
I affirm that I am an Alabama resident or resident of one of the following Georgia counties: Bartow, Carroll, Chattooga, Coweta, Douglas, Floyd, Haralson, Heard, Paulding, Polk. (Documentation may be required.)

I am not a legal resident of Alabama or one of the above mentioned Georgia counties.

Contact Information
Home Phone:
Cell Phone:
E-Mail Address:

Previous JSU Attendance
Dates of JSU Attendance:
Previous JSU Graduate Date:

Term You Plan to Return
Fall Spring Summer
*Please note the start dates for the semester you plan to return on the Academic Calendar. Update Student Status forms completed after the last day to register for the desired term will default to the next available term.

Anticipated Program
Major:

Degree Seeking
Please check the appropriate:
I am returning as a degree seeking student.

I am returning as a non-degree seeking/transient student.

If you attended a college(s) since last attending JSU, have each college mail an official transcript of all credit coursework attempted to JSU.

Other Institutions
Name of Institution:
City, State:
Dates Attended:

Name of Institution:
City, State:
Dates Attended:


Self-Disclosure Introduction

Jacksonville State University (JSU) is committed to maintaining a safe, learning centered setting for all persons in the community. In support of this commitment, JSU requires those returning to JSU to answer questions related to disciplinary history at educational institutions and felony history. Previous disciplinary action and/or felony history will not automatically bar returning to JSU but will require review. Updates requiring review should arrive at least one month prior to start of classes.

Self-Disclosure Questions
(All students must answer these five questions)

Are you on academic probation from last college attended?
Yes No Have Not Attended Another College
Are you on academic suspension from last college attended?
Yes No Have Not Attended Another College
Are you on disciplinary probation from last college attended?
Yes No Have Not Attended Another College
Are you on disciplinary suspension from last college attended?
Yes No Have Not Attended Another College
Have you ever been convicted of a felony?
Yes No
If yes, provide an explanation of each conviction

By submitting this form, I understand that withholding information requested in this Update Student Status form or giving false information may make me ineligible for continuation at JSU. With this in mind, I certify that all of this information is true, correct and complete. Further, I agree to abide by the rules and regulations of the University. My permission is given to the University to obtain additional information pertinent to my academic record at other schools.