Academic Advisor or Program (Major/Minor) Change
Office of Student Records
Student’s Name: __________________________________________________________
Address: ________________________________________________________________
Email Address: ______________________________________Phone:_______________
Academic Advisor Change: (leave blank if there is no change)
New Advisor Requested: ______________________________________________
Former Academic Advisor: _____________________________________
(optional)
Signature* of New Advisor: _
___________________________Date:__________
Former Academic Advisor: Please forward student’s file to new Academic Advisor. Thank you.
Declaration or Change of Major(s) and/or Minor(s):
List all current/desired majors or minors. Anything not listed will be removed.
Major(s):___________________________________________________________
___________________________________________________________________
Minor(s): ___________________________________________________________
Student Signature: ___________________________________Date:__________
(For office use) Copy to former advisor
_____
1511 Poly Drive, Billings, MT 59102406-657-1030 / 800-877-6259 / Fax 406-657-1169
rev 4/2019
*An email from the new advisor may be forwarded or sent to studentrecords@rocky.edu to approve this request.
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