Fillable Change-of-objective Request to Change Objective

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Change-of-objective Request to Change Objective

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Enrollment Management
Registrar's Office
One University Drive
Camarillo, CA 93012
Phone: (805) 437-8500
Request to Change Objective
For currently enrolled post-baccalaureate students wishing to enroll in a different program, an additional program, or
adding/changing a program emphasis. Directions: Complete Section 1 and submit in person, mail, or e-mail to the Registrar's Office for processing
Section 1: Student Information
Name __________________________________________ Student ID ________________ Cell Phone
________________
TERM APPLYING FOR: _______________ Current Program: _____________________________ Catalog Year: _________
Change Program Add Program Drop Program Add Emphasis Change Catalog Year Change Emphasis
Master’s: ___________________________________________________________________ Catalog Year: ________
Credential: _________________________________________________________________ Catalog Year: ________
Second Bachelor’s: _______________________________________________
BA BS Catalog Year: ________
Separate program application, transcripts, test scores and/or other documentation may be required. Please inquire with program for more
information.
Student’s Signature _____________________________________________________________ Date __________________________
Section 2: ADMINISTRATIVE USE ONLY: REGISTRAR'S OFFICE
Current Program ______________ New/Additional Program _______________ New/Additional Emphasis _______________
Resident Status __________ Current academic Standing _________ UGRD GPA
_____ PBAC GPA _____ Last 60 units _____
Print Name ___________________________________________ Signature _____________________ Date ___________
Section 3: ADMINISTRATIVE USE ONLY: PROGRAM REVIEW
Print Name ___________________________________________ Signature _____________________ Date ___________
Administrative Use Only – Registrar's Office
Pro
cessed by ___________ PS Update: ___________ ERS Panel Updated: ___________ Student/Dept Notified: ___________
(Date)
Revised 4/4/2019
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Change-of-objective Request to Change Objective

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Completed 12 March 2020

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