Fillable CHANGE / ADD OF PROGRAM AND ADVISOR (Ilisagvik College)

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CHANGE / ADD OF PROGRAM AND ADVISOR (Ilisagvik College)

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CHANGE / ADD OF PROGRAM AND ADVISOR
The change of program can be submitted during any registration.
TO BE COMPLETED BY STUDENT: (Please Print)
Name:
SS # :
(Last) (First) (Middle)
Mailing Address:
PO Box City State Zip Code
This change is requested to be effective with the
THIS IS TO: ADD PROGRAM
CHANGE PROGRAM
New Degree:
A.A. A.S. A.A.S. Certificate Endorsement
New Program:
**If your ADVISOR change. You need Former Advisor’s Signature and New Advisor’s Signature.
**If your ADVISOR do not change. She/He needs to sign as Former Advisor ONLY.
THIS IS TO:
CHANGE ADVISOR
Former Advisor:
New Advisor:
Current Program:
Student Signature:
Date:
**Former Advisor Signature:
Date;
New Advisor Signature:
Date:
Dean of Academic Affairs Signature:
Date:
Registration Office Signature:
Date:
Office of the Registrar
P.O. Box 749
Barrow, AK 99723
Phone: 907.852.1757 or 1763
Fax: 907.852.1784
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CHANGE ADD OF PROGRAM AND ADVISOR (Ilisagvik College)

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Completed 25 July 2020

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