READMISSION APPLICATION

PERSONAL INFORMATION

USE ONLY LEGAL NAME

*Last Name (Family Name):

*First Name (Given Name):

Middle Name:

Additional family name(s) under which you have been registered:

*Date of Birth:

Month

Day

Year

Your preferred first name will be used in lieu of your legal first name for the following services on campus: attendance sheets, student account, student email, Moodle portal, library account, security badge, career services database, company day roster, and graduation program.

Your legal first name will be used for any contract or financial documentation like financial aid awards or employment on campus. These lists are not exhaustive. Please enter a preferred first name that would be appropriate for a professional environment. If no preferred name is entered, legal first name will be used.

Students may submit ONE preferred name change at no cost. However, any preferred first name changes after the initial one will incur a $75 fee to cover administrative and material costs. Reverting to current legal name or officially changing legal name will not incur a fee.

Preferred First Name:

CONTACT INFORMATION

Please notify DigiPen immediately if your contact information changes at any time during the application process

*Student Email:

*Telephone Number:

Mobile Phone Number:

Create a password for your application.
Passwords must have at least 6 characters and may contain any of the following:
Uppercase letters, lowercase letters, numbers and symbols.

*Password:

*Confirm your password:

6-character minimum; case sensitive

OPT-IN TEXT MESSAGES
Select the checkbox below if you'd like to receive text messages.

Please text me important personal messages related to my DigiPen application or enrollment status.

Mobile phone to receive text msg:

This feature is only applicable to US mobile phone numbes and
it should not include any characters (space, dash, dot, brackets, etc...) except for numbers.

Current Mailing Address

*Street and number:

Apartment:

*City:

[*]State (if US or Canada):

[*]Province (if Int'l):

[*]Zip Code (if US):

[*]Postal Code (if not US):

*Country:

Permanent Mailing Address

Same as Current Address

Other

*Street and number:

Apartment:

*City:

[*]State (if US or Canada):

[*]Province (if Int'l):

[*]Zip Code (if US):

[*]Postal Code (if not US):

*Country:

Daytime Telephone Number:

FAMILY/EMERGENCY CONTACT INFORMATION

*Last Name (Family Name):

*First Name (Given Name):

*Relationship To Applicant:

Contact Information: Same as Current Address Other

*Street and number:

Apartment:

*City:

[*]State (if US or Canada):

[*]Province (if Int'l):

[*]Zip Code (if US):

[*]Postal Code (if not US):

*Country:

Telephone Number:

CITIZENSHIP INFORMATION

Specify your citizenship U.S. CitizenForeignPermanent Resident

If Foreign or Permanent Resident:

Country of citizenship?

Country of birth?

If you are a U.S. citizen living OUTSIDE the United States, you may be asked to provide proof of citizenship.
If you are a PERMANENT RESIDENT, please send us a copy of your residency card

Current or expected visa type and expiration date (Skip if US Citizen)

or permanent resident number A-

If Foreign:

Are you currently studying at another U.S. institution under F1 visa? No Yes

Please provide a foreign address:

Same as Current Address
Same as Permanent Address
Other

*Street and number:

Apartment:

*City:

[*]State (if US or Canada):

[*]Province (if Int'l):

[*]Zip Code (if US):

[*]Postal Code (if not US):

*Country:

Daytime Telephone Number:

TO WHICH DEGREE PROGRAM ARE YOU NOW APPLYING FOR READMISSION?

CRIMINAL / DISCIPLINARY HISTORY

Although DigiPen inquires about applicants' disciplinary or criminal violations, answering "yes" to this question does not necessarily disqualify an applicant. Program evaluators will not have access to this information when conducting their review for admissibility. The answer to this question will not be considered until a preliminary assessment of academic fit with DigiPen is made.

Do you have any prior history of being found guilty or convicted of or responsible for a disciplinary violation or criminal offense? "Prior history" includes conviction in a court of law or a finding by any institution, including any military tribunal or educational institution (from the 9th grade forward, any institution of higher education, or the international equivalent) or their equivalent.

If "yes", please provide a written explanation about what happened, including details regarding the circumstances, charges of which you were found guilty or convicted or responsible for, and the punishment which you received, and what you may have learned from these experiences.

All items including, but not limited to, application forms, transcripts, recommendation letters, resumes, software, and accompanying documentation or works of art (collectively 'the Items'), forwarded to DigiPen Institute of Technology by any person ('the Sender'), whether at the request of DigiPen or otherwise, become the exclusive property of DigiPen unless otherwise agreed to in writing by DigiPen, and DigiPen shall be under no obligation whatsoever to return the items to the Sender. At DigiPen's discretion, the Items may be destroyed after being reviewed. DigiPen will notify applicants upon receipt of this application form. If the sender is accepted and then enrolled into DigiPen, DigiPen Institute of Technology may share the personal information provided in this application to other departments to ensure the delivery of educational services, including but not limited to a computer log-in, Student ID, library card, and other related services.

By clicking Accept, I, the applicant, agree and accept that withholding information in this application, failure to submit all documents, or giving false information may make me ineligible for admission to, or continuation at, DigiPen Institute of Technology. Upon submission of this document, I certify that all of the statements I have made in this application are correct and complete to the best of my knowledge. Additionally, I waive the right to view any recommendation letters sent to DigiPen Institute of Technology on my behalf. I hereby give permission to release any academic records requested by DigiPen Institute of Technology.

Gainful Employment Disclosures

In October of 2010, the U.S. Department of Education approved regulations requiring institutions that participate in federal student financial aid programs to publicly disclose certain information about students who enrolled in programs that lead to gainful employment in a recognized occupation (which the Department refers to as "GE Programs"). As a Domestic Proprietary Institution offering undergraduate and graduate degrees, all of DigiPen's degree programs qualify as GE Programs. The following section lists the information required by the Department of Education pertaining to each degree program and clarifies what this information means to prospective students.

The Gainful employment acknowledgement is required to submit your application.
To submit your application please review and acknowledge the template.

Failed to submit your application!

The system failed to submit your application due to unknown reasons. Click Back and try again, or choose Cancel to quit.

Your application has been submitted successfully!