Change of Status Form
Student's Name (Last, First, MI)
A change of admit status on the student listed above is to be processed due to the reason(s) checked below (check all that apply).
GPA on 9 hours or total taken while completing 9 hours. (Masters: 3.0; Specialist: 3.25; Doctoral: 3.5)
Other department requirements have been satisfied..
Student has no incomplete grades.
The student listed above did not meet the required conditions to be changed to regular admission. Therefore, the student is
dismissed from the program. (Attach Dismissal Form & Dismissal Letter)
Print Name below Signature
School Director School Director
Dean, Grad Sch Dean, Grad Sch
Degree Auditor Degree Auditor
Admission Status (has completed the REQUIRED conditions to be changed from Conditional to Regular Admission Status).