Returning Student and Temp ICT Form

• Spring
• Summer
• Fall

• Returning Student (previously enrolled as an O'Neill student on the Bloomington campus)
• Temporary Intercampus Transfer
  (previously or currently enrolled as an O'Neill student on another IU campus and just taking classes through IUB on a temporary basis)

• Yes
• No

We are committed to maintaining a safe learning environment. As part of that commitment, Indiana University requires applicants to disclose information pertaining to any of the circumstances described below. A previous disciplinary action, charge, conviction, or conduct of the sort identified here does not automatically disqualify students from returning to IU, but they do require review by the campus admissions committee.

Have you been subject to formal disciplinary action (including for example, but not limited to, suspension or expulsion) for academic or non-academic reasons at any high school, post-secondary institution, college, or university?

• Yes
• No

Have you ever been charged with or convicted of a crime (or a foreign legal equivalent) that has not been expunged by a court?

• Yes
• No

Do you have any currently pending criminal charges (or a foreign legal equivalent) against you?

• Yes
• No

Have you engaged in any behavior that caused injury to any person(s) or property (including, for example, but not limited to, vandalism or behavior that led to a restraining order against you) which resulted in some form of discipline or intervention?

• Yes
• No

• By checking the box below, I verify that all the information provided is true and accurate. I understand that if I provide misrepresented or incorrect information related to the Behavior Disclosure, formal disciplinary action including cancellation of my enrollment can occur.