Judson University - Ambria College of Nursing
Readmit Student Commitment Form

This form should only be completed once ALL the admissions requirements have been met and you have been formally re-admitted to the nursing program. If you are a brand new applicant, DO NOT use this form.

Candidacy Information

NOTE: An academic year consists of 3 terms. For example, the 2024-2025 Academic Year contains the Fall 2024, Spring 2025, and Summer 2025 semesters.

What year do you plan to return to your studies?

What term do you plan to return to your studies?

Confirm the degree program you are returning to.

Confirm the program of study you are returning to.

Name Information

First Name

Middle Name

Last Name

Suffix

Gender

Marital Status

Birth Date

SSN

Citizenship Information

Citizenship Status

Citizen Of

Race Information

Race (Choose one or more)

Ethnicity

Military Information

Do you plan to draw from VA Benefits while at Judson?

Contact Information

Do you reside outside of the United States?

Address Line 1

Address Line 2

City

State

Zip Code

County (IL only)

Country

Primary Phone Number

Email Address

Confirm Email Address

Emergency Contact

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip Code

Country

Email

Phone Number

Relationship

School Information

If you attended another college or university after leaving Judson, please complete the section below.

Add a row for each institution you attended by entering the school information below and clicking "Save." You may enter as many records as needed. 

Use the "State" drop-down to help limit the search for schools. If your school is not listed, select "School Not Listed" and type your former school name. If your degree does not appear in the drop-down, select "Field of Study Completer."

State of Institution

Institution

Name of Institution

Degree

Graduation Date

Please upload a copy of your readmit acceptance letter, or documentation of your clearance/approval to return.

Nursing is a rigorous program, and requires a high level of dedication from students. Download the "Registration Terms and Conditions" document to review the expectations of students.

Upload the signed copy of the Registration Terms and Conditions.

Please review your information by clicking the tabs. When all information is complete, click "Submit." The form may take a few moments to process. Please do not close or refresh your browser while the system collects your information. You will see a completion screen when the form has been successfully submitted.