ࡱ> rtopq bjbj)) 4VCgCg :::::NNNNTN(&fffffUUU`(b(b(b(b(b(b($+-(:UUUUU(::ff(U:f:f`(U`(V!@|"fR\k ! L((0("xk.uk.|"k.:|"UUUUUUU((UUU(UUUUk.UUUUUUUUU X : 91Թ College of Pharmacy Request for Readmission FormInstructions:Complete sections 1, 2 and 3 below. Save the file as [your name readmit request-date.docx]. Ex. Lisa Jackson-readmit request-1-1-2023. Please complete, sign and submit the form to cop-readmit@xula.edu. Or, deliver the form to the COP Office of Student Affairs - (Rm. 100). Attn: Director of Admissions. Note: Please type form responses. Section 1:Student InformationLast Name:First NameStudent ID:AddressCityStateALPhone #:Xavier email:Alternate email:Last Semester/ year attended Requested Readmission Semester/year: Last Academic Standing (Select X one)DismissalWithdrawal-AcademicOther (specify)Withdrawal-PersonalSection 2:Readmission Impact StatementParagraph 1 Explanation of extenuating circumstances. Please provide below a concise explanation of the extenuating circumstances (those personal events beyond your control) which have directly affected your academic performance. In your explanation, please discuss when the particular event(s) occurred, how long you were affected, and what course(s) were affected  Last name, First nameRequest for Readmission Form (pg 2)  Section 2:Readmission Impact Statement (continued)Paragraph 2Steps taken to resolve extenuating circumstances. Please outline what steps you took to deal with the extenuating circumstances during or after the occurrence (e.g., consultation with a health care professional or personal counselor, participation in the Academic Enrichment Program, meeting with course coordinator or course instructor).Paragraph 3Plan for achieving/maintaining academic success. 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