IMPORTANT: By completing this form, you are declaring that you have NOT attended and will not attend another college since applying to SUNY Canton. If it is determined that you have attended another college since applying to SUNY Canton, your admission to SUNY Canton may be rescinded.

Students Who Can Fill out this Form:

Any student who has previously applied to SUNY Canton within the last year, was admitted or cancelled for incompletion, and has not completed the enrollment process.

Students Who Should Not Fill out this Form:

Any student who has completed the enrollment process at SUNY Canton and subsequently withdrew from the college after the semester has begun.
Any student who was denied from SUNY Canton, as a new application must be submitted.

Personal Information

Canton ID

Student First Name

Student Middle Name

Student Last Name

Maiden Name

Gender Identity

Birthdate

Mailing Address (Please include apartment number, if applicable)

Country

Street

City

Region

Postal Code

Contact Information

Email Address (If possible, please avoid using your high school email, as it may be marked as SPAM)

Phone Number (Home)

Phone Number (Mobile)

School Information

Anticipated Start Term

Intended Major

Reference

Do you plan to be?

Do you plan to study online?

Do you wish to be reviewed for EOP?

Are you a New York State resident?

Are you a U.S. citizen?

Have you ever been dismissed from a college for disciplinary reasons?