1 Instructions 2 Residency 3 Other Colleges 4 Reenrollment Term 5 Review 6 Complete Complete this form if you: are a formally admitted undergraduate or post-baccalaureate student; and have been away from the University four or more terms (not including summer sessions); and you have not received a bachelor’s degree from another institution since last attending UO. If you are an international student, contact the Office of International Programs regarding immigration documents. For more information, visit https://registrar.uoregon.edu/reenrollment. Contact Information This information will be used to verify your identity. Name Last * First * Middle Name(s) Previous Name(s) List any and all former names. Use a comma to separate multiple names. UO ID# If known. Email Address * You will be contacted at this address. Phone Number * Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year1924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026 Mailing Address Address Line 1 * Address Line 2 City * State/Province/Region * ZIP/Postal Code * Country United States of AmericaAfghanistanAlbaniaAlgeriaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurma (Myanmar)BurundiCambodiaCameroonCanadaCape VerdeCayman IslandsChileChinaChristmas IslandColombiaCongo, Democratic Republic of theCosta RicaCote D`IvoireCroatiaCubaCyprusCzech RepublicDenmarkDominican RepublicDPR KoreaEcuadorEgyptEl SalvadorEritreaEstoniaEthiopiaFijiFinlandFranceFrench Southern TerritoriesGabonGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgystanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaliMaltaMartiniqueMauritaniaMauritiusMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMoroccoMozambiqueNamibiaNepalNetherlandsNetherlands AntillesNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRepublic Of KoreaReunionRomaniaRussiaRwandaSamoaSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSomaliaSouth AfricaSpainSri LankaSt. Kitts and NevisSt. LuciaSt. Vincent and the GrenadinesSudanSurinameSwazilandSwedenSwitzerlandSyriaTahitiTaiwanTajikistanTanzaniaThailandThe BahamasThe GambiaTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnknownUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabwe Permanent AddressIf different than mailing address. Address Line 1 Address Line 2 City State/Province/Region ZIP/Postal Code Country - None -United States of AmericaAfghanistanAlbaniaAlgeriaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurma (Myanmar)BurundiCambodiaCameroonCanadaCape VerdeCayman IslandsChileChinaChristmas IslandColombiaCongo, Democratic Republic of theCosta RicaCote D`IvoireCroatiaCubaCyprusCzech RepublicDenmarkDominican RepublicDPR KoreaEcuadorEgyptEl SalvadorEritreaEstoniaEthiopiaFijiFinlandFranceFrench Southern TerritoriesGabonGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgystanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaliMaltaMartiniqueMauritaniaMauritiusMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMoroccoMozambiqueNamibiaNepalNetherlandsNetherlands AntillesNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRepublic Of KoreaReunionRomaniaRussiaRwandaSamoaSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSomaliaSouth AfricaSpainSri LankaSt. Kitts and NevisSt. LuciaSt. Vincent and the GrenadinesSudanSurinameSwazilandSwedenSwitzerlandSyriaTahitiTaiwanTajikistanTanzaniaThailandThe BahamasThe GambiaTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnknownUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabwe Leave this field blank