Return this completed form to the Admissions and Records Office, or scan and email from your Gadsden
State email account to
Student’s Name: ______________________________________ Student ID (G#): __________________
Email: _______________________________________________Phone Number: __________________
Current Major/Program of Study:_________________________________________________________
See the College Catalog for a list of degrees and majors.*
*Please note that all major changes will be effective for the following semester unless specifically requested to be
changed due to Financial Aid eligibility reasons.
New Degree: A.S. Degree A.A.S. Degree Certificate Short-Certificate
New Major/Program of Study: __________________________________________________________
New Area of Interest (for General Studies only): ____________________________________________
Are you receiving financial aid? Yes* No
*Please note that classes taken outside of your program of study/major may not be covered by financial aid.
Have you applied for Graduation? Yes No If yes, what term? __________________________
Student’s Signature*___________________________________ Date: ___________________________
*By signing, I acknowledge and understand that by changing my program of study, my academic catalog will be
changed and make me subject to graduation requirements based on the current Gadsden State Community College
Separate program acceptance is required for Diagnostic Medical Sonography, Emergency Medical
Services, Massage Therapy, Medical Lab Tech, Radiology, Registered Nursing, and Court Reporting.
Program Director______________________________________ Date: ___________________________
Admissions & Records Office | P.O. Box 227 Gadsden, Al. 35902-0227 | (256) 549-8210 |
(REV 11/18)
Records Office
Processed by:________________________________________ Date:_____________________