Re-Admission Application For On-Campus Coursework

Fields marked by an asterisk (*) are required.

Title:
First Name: *
Middle Initial:
Last Name: *

Other name(s) under which may be on your record.

Loyola Campus Wide ID: *
(Student ID number formerly assigned by Loyola for international students.)

Address 1: *
Address 2:
City: *
State: Zip Code:
Country:
Home Phone: *
E-mail: *
Fax Number:
Work Phone:

Date of Birth: *

You are re-applying as a: Graduate Student CEU Student *

If known at this time, please mark the focus area you intend to study:
    Parish Life and Administration
    Marketplace Ministry
    African American Ministries
    Christian Spirituality for Pastoral Ministry
    Religious Education
    Youth Ministry
    Small Christian Community Formation
    Hispanic Ministry
    Religion and Ecology

Anticipated Start Date

I graduated from:
    LIM On-Campus
    LIMEX

I certify that the information in this application is accurate and complete, and I acknowledge that any omission or inaccurate information could jeopardize my standing with Loyola University New Orleans. My name and date below serves in lieu of my signature.

Signature * Date *

I am not interested in a focus course at this time, but please update my mailing address and email address in the LIM alum records.

LIM Enrollment Office
Loyola Institute for Ministry
6363 St. Charles Avenue, Box 67
New Orleans, LA 70118

Fax: 504-865-2066

email: limenrol@loyno.edu

If you have any problems with this form, please e-mail the webmaster.

Updated September 18, 2008