UNDERGRADUATE UNIVERSITY DIVISION PETITION FOR REINSTATEMENT

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Name:___________________________________________________________

PID: _____________________________________________________________

Date: ____________________________________________________________

Current Major: ____________________________________________________

Alternative Major (if any): ___________________________________________

Current Academic Status

Current GPA ________

Number of Repeat credits ________

Credits yet to be repeated (20 max.) ________

Total number of credits earned ________

Do you attribute any of your academic difficulties to your current major? Yes / No

What are your special circumstances for requesting reinstatement to Michigan State University at this time?











What are the specific factors that led to your academic difficulty?

Academic Plans if Reinstated

If reinstated, what are your immediate plans for resolving your academic difficulties?














If reinstated, what courses do you plan to take during your first semester back?

Course	Repeat (Yes / No)	Original Grade (if repeat)

Academic Support Strategies:



















If approved for reinstatement, you are expected to comply with all the conditions of this reinstatement.

If your request for reinstatement is denied, what do you plan to do during your period of recess?












Student Signature ______________________________________________

Date _____________

You must bring this completed petition with you at your scheduled appointment to appeal your recess status.