Northeast TN Reconnect Community Intake Form

Tennessee Reconnect is a FREE service to help adults find their way back to and through college. Congratulations on taking your first steps today to reconnecting to college!
Northeast TN Reconnect Community
Please fill out as many of the questions below as possible so that we can serve you better, faster, and more effectively. Remember: our services are always FREE.  We will NEVER sell or give away your information. 

This form may take you 5-10 minutes to complete, but it will allow us to immediately tailor advising services to you and other opportunities. After you submit the form, you will see a page with important information on next steps. 

Thank you, and we look forward to assisting you,
The Northeast TN Reconnect Community Advising Team


















The following information is considered confidential by many people. We are concerned with your privacy as well. Please know that this information is used only in aggregate, for fund-raising purposes, so that we may continue to provided our services for free. We appreciate your support as you consider providing the requested information.









Please provide some information about your educational goals. 






By submitting this form I give permission to Northeast Tennessee Reconnect Community to forward my information to its partner institutions for purposes of assisting with my college admissions/enrollment.

I give permission to the Admissions/Office of Enrollment Management/Registrar of the College/University I shall be attending to release to Northeast Tennessee Reconnect Community information verifying my enrollment status and my official transcript.

I fully understand that all information given on this application and information released to Northeast Tennessee Reconnect Community or its partner institutions is protected by the Family Educational Rights and Privacy Act of 1974 and, therefore will be kept confidential. Northeast Tennessee Reconnect Community promises it will NEVER sell or give away personal information.

I certify that all information that I have provided on this application is accurate and true to the best of my knowledge and ability.

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