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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