Request to Return

If you are currently not enrolled at the College due to a prior Leave of Absence, College Withdrawal, Academic Suspension or Academic Dismissal, please complete this form to indicate that you are interested in returning to Merrimack for the upcoming semester. Currently enrolled students do not need to complete this form.

If you are requesting to return following an Academic Suspension or Academic Dismissal, upon review of your form you will be asked to share additional information regarding your eligibility to return.

* denotes required field

Contact Information

First Name*

Last Name*

Merrimack ID Number*

Merrimack Email Address*

Are you a*

undergraduate student

graduate student

Alternate Address* (we will send communications to this account as well as your Merrimack account)

Are you an international student on an F1 Visa?*

Yes

No

I don't know / I'm not sure

Disciplinary History

Have you ever been involved in or found responsible for a disciplinary violation at an institution other than Merrimack College?

Yes

No

Have you ever been convicted of a misdemeanor, felony, or other crime?

Yes

No

If you selected "yes" to either of these questions, please provide an explanation with details.

Upload documentation, if appropriate

Academic Information

Welcome back! We're excited you've decided to register for classes. Please let us know who you'd like to work with to talk about your classes and return to Merrimack.

Academic Success Coach

Assistant Dean of Student Advising / School Advising Staff

Faculty / Major Advisor

Please let us know that you are interested in registering for classes for the upcoming semester.*

I CONFIRM my intent to enroll for the upcoming semester.

I am completing this form for*

Year*

Have you taken any college courses while you were on a Leave of Absence from Merrimack?*

DeleteCourse _ID_
Please indicate college: (Please begin typing and select from the drop-down menu.) School CEEB* Course*

Add another course

Please visit https://www.merrimack.edu/academics/polices_procedures/transfer-credit/ for more information about how to transfer credits.

Housing Information

Please choose a response*

I would like to live on campus as a residential student. (Please watch your Merrimack email for an announcement of the housing deposit deadline.)

I would like to commute to campus as a commuter student.

I am enrolled in a fully online program.

Signature*

Click to Sign...

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Request to Return