RETURNTO:Admissions&RecordsOceMAILTO:ATTN:Mailbox24,2700E.LelandRoad,Pisburg,CA945645FAXTO:(925)4276351
DECLARATIONORCHANGEOFMAJORFORM
REV.1172013
 A=TransfertofouryearcollegewithAssociatedegree
 B=TransfertofouryearcollegewithoutAssociatedegree
 C=EarnAssociatedegreeinGeneralEducaon
D=EarnAssociatedegreeinVocaonalSubject
E=EarnCercateofAchievement
WhatisyoureducaonalgoalatLMC?(CheckOne)
Areyoufollowingthetransferpath?YesNo
Ifso,whichTransferPath?CSUIGETC
PRIMARYMAJOR
DegreePursuing:(CircleOne)AAASAATASTCA
SECONDMAJOR(NotconsideredforFinancialAid.)
Degree:(CircleOne)AAASAATASTCA
THIRDMAJOR(NotconsideredforFinancialAid.)
Degree:(CircleOne)AAASAATASTCA
Listallthemajorsyouareworkingtowards.ForFinancialAidrecipients,wewilllistyourrstmajorasyourprimary
major.ThiswillnotinterferewithyourFinancialAid.Anyothermajornotlistedonthisformwillbeclosed.
* CerƟcates not approved for Financial Aid (See CerƟcate of Achievement Table).
LMCMajors(Listofmajorsavailableonthebackofthisform.)
LMCID#: DATE:
Please print legibly in blue or black ink.
NAME(Last,First,Middle):
SIGNATURE
CercateofAchievement(SelectEducaonalGoal:E)
 *BasicLawEnforcementIntensive‐CA.BLEI.LMicrocomputerSystemsSpecialist‐CA.COMSC.L
 *BasicLawEnforcementIntermediate‐CA.BLET.LNetworkingandSecurity(Basic)‐CA.COMNB.L
 *BasicLawEnforcementAdvanced‐CA.BLEA.LNetworkingandSecurity(Advanced)‐CA.COMNS.L
AdministraonofJusce‐CA.ADJUS.LElectricalTechnology‐CA.EETEC.L
*CriminalInvesgaons‐CA.AJCIS.LInstrumentaonTechnology‐
CA.EETI
E.L
*CriminalLaw‐CA.AJCLS.LFireTechnology‐CA.FIRE.L
 ApplianceTechnicianI‐CA.APPLE.LManagementandSupervision‐CA.MANSU.L
 ApplianceTechnicianII‐CA.APPLI.LMusic,Commercial‐Bus.Management‐CA.MUSBM.L
 GraphicCommunicaon‐CA.ARTGC.LMusic,Commercial‐Performance‐CA.MUSPF.L
 AutomoveTechnology‐CA.AUTO.LMusic,Commercial‐Pedagogy‐CA.MUSPD.L
 Business:Accounng‐CA.BUSAC.LNursing,VocaonalNursing‐
CA.VONUR.L
 Business:OceAdministraon‐CA.BUSOA.LProces
sTechnology‐CA.PTEC.L
 Business:SmallBusinessOperaons‐CA.BUSSB.LRealEstate‐CA.REAL.L
 Business:RetailManagement‐CA.BUSRM.LRecordingArts‐CA.REART.L
 ChildDevelopment‐CA.CHDEV.LTravelMarkeng‐CA.TRAVL.L
 ComputerSupportSpecialist(Basic)‐CA.COMSB.LWeldingTechnology‐CA.WELD.L
 ComputerSupportSpecialist(Advanced)‐CA.COMSS.L
AA/ASVocaonal/CTEDegrees(SelectEducaonalGoal:AorD)
 AdministraonofJusce‐AS.ADJUS.LElectricalTechnology‐AS.EETEC.L
 ApplianceServiceTechnology‐AS.APPLI.LInstrumentaonTechnology‐AS.EETIE.L
 AutomoveTechnology‐AS.AUTO.LFireTechnology‐AS.FIRE.L
 Business:Accounng‐AS.BUSAC.LManagementandSupervision‐AS.MANSU.L
 Business:SmallBusinessOperaons‐AS.BUSSB.LNursing,RegisteredNursing‐AS.RNURS.L
 Business:OceAdministraon‐AS.BUSOA.LProcessTechnology‐AS.PTEC.L
 Computer
Science‐AS.COMSC.LRealEstate‐AS.REAL.L
 ComputerScience:SupportSpecialist‐AS.COMSS.LTravelMarkeng‐AS.TRAVL.L
 ComputerScience:NetworkingandSecurity‐AS.COMNS.L WeldingTechnology‐AS.WELD.L
AA/ASGeneralEd/LiberalArts/TransferDegrees(SelectEducaonalGoal:A,B,C)

Anthropology‐AS.ANTHR.LJournalism‐AA.JOURN.L

Art:FineArts‐AA.ARTFA.LLiberalArts:Arts&Humanies‐AA.LAAHU.L

Art:GraphicCommunicaons‐AA.ARTGC.LLiberalArts:Behavioral&SocialScience‐AA.LABSS.L

BiologicalScience‐AS.BIOSC.LLiberalArts:Math&Science‐AA.LAMSC.L

Chemistry‐AS.CHEM.LMathemacs‐AS.MATH.L

Drama:Acng‐AA.ACT.LMusic‐AA.MUSIC.L

Engineering‐AS.ENGIN.LRecordingArts‐AA.REART.L
WhatisyourMAJOR/PROGRAMatLMC?(CheckOne)
AAT/ASTAssociateDegreeforTransfer(SelectEducaonalGoal:A)

BusinessAdministraonforTransfer‐AST.BSADM.L KinesiologyforTransfer‐AAT.KINES.L

EarlyChildhoodEducaonforTransfer‐AST.CHDEV.LPhysicsforTransfer‐AST.PHYS.L

CommunicaonStudiesforTransfer‐AAT.COMST.LPsychologyforTransfer‐AAT.PSYCH.L

Drama:TheatreArtsforTransfer‐AAT.THART.L SociologyforTransfer‐AAT.SOCIO.L
AdministraonofJusce‐AST.ADJUS.LHistory‐AST.HIST.L