Rev. 02/2020
Change of Major/Concentration/Minor/Certification/Certificate
__________________________________________________________________________________________
Name Student ID#
Major: □ Change
From: _________________________________ To: _________________________________
Concentration: □ Change □ Add □ Drop
From: _________________________________ To: _________________________________
Minor: □ Change □ Add □ Drop
From: _________________________________ To: _________________________________
Education
Certification: □ Change □ Add □ Drop
From: _________________________________ To: _________________________________
Certificate: □ Change □ Add □ Drop
From: _________________________________ To: _________________________________
Please obtain signatures in the following order:
___________________________________________________________ ______________________________
Student Signature Date
___________________________________________________________ ______________________________
Current Advisor Signature Date
___________________________________________________________ ______________________________
Current Department Chair Signature Date
___________________________________________________________ ______________________________
New Department Chair Signature Date
Name of new advisor as assigned by new Department Chair _________________________________________
___________________________________________________________ ______________________________
Director of International Studies Signature (if applicable) Date