RPI Graduate Admissions: Graduate Enrollment Confirmation
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Graduate Student Enrollment Confirmation of Intent

Rensselaer ID Number (RIN)
Last Name
First Name
Middle Initial optional
Street Address1
Street Address2 optional
State/Province optional
Postal Code optional
Mailing Address Good Until
Email Address
Phone Number optional
Graduate Degree Program
Department of Study optional
Degree Goal optional
I am a member of the armed forces of the United States serving in/on (optional):
Active Duty
Ready Reserve
Individual Ready Reserve (IRR)
Standby Reserve
Inactive Ready Reserve
Not a member
Not applicable
I plan to enroll: Yes

Return form by June 1 for fall enrollment, and by December 1 for spring enrollment to: Rensselaer Admissions, Graduate Programs, Rensselaer Polytechnic Institute, Troy, NY 12180-3590

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* RPI Graduate Admissions, 110 8th St., Troy, NY 12180   (518) 276-6216   admissions@rpi.edu *
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