Date:
Name: BannerNo.
Last First MI
Currentclassification:
Major: Concentration:
Track: Minor:
CURRENT NEW
BulletininUse:
YEARS
Bulletin:
YEARS
SIGNED:
Student Date
SIGNED:
Advisor Date
SIGNED:
Chair Date
INSTRUCTIONS:Thisformshouldbecompletedbythestudent,signed,andsubmittedtotheiradvisorfor
discussionandsignature.Thestudentandadvisorshouldverifyanychangesinprogramrequirements
beforesubmittingthisformfurther.TheDepartmentwillforwardtheformtotheOfficeoftheRegistrar
whereitwillbecomepartofthestudent’spermanentacademicrecord.
OfficeofAcademicAffairs
AlabamaA&MUniversity
BulletinAcknowledgementForm
Rev.01/2019
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