Declaration/Change of Program
Degree, Major, Concentration and/or Minor
Registrar’s Office Halifax NS B3M 2J6 (902) 457-6117 FAX (902) 457-6498 registration@msvu.ca
Use this form to request a change in your degree, declare/change your major, concentration and/or minor. Complete the
form, obtain signatures from the appropriate Department Chairs as required, and return the form to the Registrar’s Office.
______________ _________________________________ _________________________________________
Student ID# Last Name First Name(s)
_______________________________________ ______________________ __________ ___________
Apartment/Street Town/City Province Postal Code
__________________________ (_____)____________ ________________________________________________
Current Program of Study Phone Number Mount Email Address
Change of Degree
______________________________________________
New Degree Program
______________________________________________ ________________________
Department Chair’s Approval Signature Approval Date
(subject to review by Admissions)
______________________________________________ ________________________
Admissions Approval Signature Approval Date
□ Declaring Major □Changing Major □Deleting Major □Adding Second Major
______________________________________________ ______________________________________________
Major Major (2)
______________________________________________ ______________________________________________
Department Chair’s Approval Signature Department Chair’s Approval Signature
________________________ ________________________
Approval Date Approval Date
Declaration/Change of Concentration
I am:
□ Replacing existing
□ Adding new ___________________________________ _______________________________________
□ Deleting Concentration (1) Concentration (2)
Declaration/Change of Minor(s)
I am:
□ Replacing existing
□ Adding new ___________________________________ _______________________________________
□ Deleting Minor (1) Minor (2)
____________________________________________
_____________________________________________
Date
Student Signature
Mount Saint Vincent University abides by the Personal Information Protection and Electronic Documents Act (PIPEDA) and the Freedom of
Information and Protection of Privacy (FOIPOP) Act. For further information on these acts, please refer to the University Calendars.
Note: This form cannot be used if you wish to change
your program to BPR or BEd degree, as these are
limited enrolment programs. You must formally apply
through the Admissions Office.
Have you recently applied to Graduate (Please note this is not an application to Graduate)
Please check myMount to confirm your declaration/change.
□ Yes □ No
