Applicant Name
First Name Middle Name
Last Name Suffix
If you have academic records under another name, please indicate below:
Former First Name Former Last Name
Select all that apply:
Current Catalog Year: ____________________ New Catalog Year: ____________________
Signature of Advisor/Department Chair: ________________________________________________
Date
Indicate New Program of Study:
Code (If known)
If you selected one of the following majors, select a concentration:
Health and Wellness Promotion (2440.HWP) Industrial Technology (583B.MET)
Information Technology (1492.INT) Sports and Leisure Studies (2874.SLS)
Teaching Assistant (1330.TEA)
ECC ID Date of Birth
Home Phone Cell Phone
ECC Email Address
I hereby acknowledge by signing this document of application to Erie Community College, I will be held personally and legally
responsible for any debts or liabilities incurred at the institution. Financial obligations may include all tuition liabilities, fees, books,
childcare, and other extraneous costs. If legal action must be taken for restitution, I will be responsible for all collection and legal costs.
Applicant Signature ________________________________________________________________________________ Date ______________
(See reverse for instructions)
SUNY Erie Community College
Change of Curriculum Form
Change Catalog Year
Change Campus
Change Major
Select a Campus:
City
North
South
Online
Select a Campus:
City
North
South
Online
Exercise Science (2440E)
Health Studies (2440H)
Cyber Security (1492C)
Management Information Systems (1492M)
Networking (1492N)
Programming (1492P)
Childhood Education (1330C)
Secondary Education (1330S)
Male
Female
Applied Technology (583PG)
Advanced Manufacturing CNC Machine Tools (583PC)
Sports and Leisure Studies (2874S)
Sports Management (2874C)
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an applicant or student. To opt out of future messages please check this box.
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Steps to Complete this Form
1. Please fill out the form completely. If you are applying for one of the programs listed below, you cannot use this form to
change your program and/or campus. You will need to fill out the online application at www.ecc.edu.
Advanced Police Science (2079.APC)
Biotechnological Science (2436.BIM)
Clinical Laboratory Technician (2188.CLT)
Dental Assisting (1353.DNA)
Dental Hygiene (545.DHY)
Emergency Medical Technology: Paramedic (1293.EMP)
Emergency Medical Technology: Paramedic Certificate (2453A.EMT & 2453B.EMT)
Food Service Administration: Dietetic Technology (573.NDT)
Health Information Technology (1969.HIT)
Medical Assisting (1967.MOA)
Nursing (622.NUR)
Occupational Therapy Assistant (665.OTA)
Vision Care Technology (549.VIS)
Police Basic Training (1827.PBT)
Radiation Therapy Technology (669.RAD)
Respiratory Care (655.RES)
Non-Matriculated (909.NNM)
2. If you are changing your Catalog Year, you must have your advisor/department chair approve of the change. Campus and
major changes do not require advisor/department chair approval.
3. Submit the completed form to the Office of Admissions at the North or South campuses or to the Student Success Center at
the City campus.
4. You will receive a confirmation email in your ECC email account within 1-2 business days stating that your request has been
approved.
10/18/19