Fillable 2021-2022 Change of Status (California State University, San Bernardino)

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2021-2022 Change of Status (California State University, San Bernardino)

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  • 18 check-boxes
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Country of origin: US
File type: PDF

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Return to:
5500 University Parkway UH 150
San Bernardino, CA 92407
Tel: (909) 537-5227
Fax: (909) 537-7024
2021-2022 Change of Status
Name: ____________________________________________ Coyote ID: __________________
Phone Number: ______________________
Please fill out the section(s) that pertain to the change(s) you are requesting:
I. ENROLLMENT CHANGES
1.
Cancel my aid as I do NOT plan to attend CSUSB for the 2021-2022 academic year
2.
I will be enrolled less than full time: Fall #units _______ Spring #units_______
3.
I will be withdrawing from all courses effective (check term): ____ Fall 2021 ____ Spring 2022
4.
I have changed my graduation date to the following term:
Fall 2021:
(You must officially update your graduation date with the Office of the Registrar)
5.
I have changed my degree objective to:
BA/BS
MA/MS
Credential
EdD.
Effective:
Fall 2021
Spring 2022
6.
Summer Session (# of units)
Session 6W1
Session 6W2
Session Regular
II. HOUSING CHANGES
7.
My housing status has changed to the following:
On Campus
Off Campus
With Parents
Date of Change/Move:
_______________
III. OTHER
I authorize CSUSB Office of Financial Aid & Scholarships to make changes to my financial aid file and
award based on this new information. I acknowledge that changes to my aid may result in a balance
due.
Signature
Date:
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2021-2022 Change of Status (California State University, San Bernardino)

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Completed 11 August 2021

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