Re-Entry Form

Kenzie Academy Re-Entry Form

Kenzie Academy offers readmission to eligible students who have to leave school for whatever reason. Rejoin the Kenzie family and complete your certificate by completing this form!

Legal First Name

Legal Middle Initial

Legal Last Name

Kenzie Email Address

Today's Date

Academic Information

Last Program Attended

Do you wish to use Federal Financial Aid (FASFA)?

How do you plan on funding your education

Payment PlanCashI'm not sure

Other Funding

Additional Information

Emergency Contact Name

Emergencency Contact Phone Number

Emergency Contact Relationship

Has your contact Information changed since your last enrollment?

Phone number, personal email, address, etc.

Has your demographic information changed since your last enrollment?

Gender, Marital Status, Citizenship, etc.

Contact Information

Phone

Personal email address

Address Line 1

Address Line 2

City

Country

State

Provinces

State/Province

Postal Code

Demographic Information

Gender

Citizenship Status

Citizenship

Hispanic/Latino

Race

Military Status

Marital Status

Acknowledgement of Terms

Please read & agree to the following terms & policies

I agree my form will be withdrawn & I will not be eligible for re-entry if I go more than 7 consecutive days without making any contact with Kenzie Staff.

I agree

I agree to the Kenzie Academy Learner Re-entry policy.

I agree

I agree that all information provided in this form is true and all documentation provided is genuine.

I agree

Thank you!

Final Chance to Review Form

You have completed the Kenzie Academy Re-entry Form! Take this time to review your previous submissions before hitting Submit. Kenzie Academy will not see your information until you hit the "Submit" button below.

Once you submit this form, your will receive a response from Kenzie Academy within 5-7 business days.