Student ID Number
Date
Name Enrolled Under (Last, First, Middle, Other)
Student Signature
Phone Number
___ ___ ___ - ___ ___ ___ - ___ ___ ___ ___
Changes are effective for the current term through the last day to add classes, but effective the following term if made after.
See back of form for a list of majors (and attached concentrations, if applicable) and minors.
List all that apply:
Primary Major:
Minor:
Secondary Major:
If you:
receive Veteran’s benefits
participate in athletics
have applied for graduation
are changing from a bachelor’s to an associate’s degree
you may want to speak with the appropriate representative before changing your
major(s)/minor; if necessary, he/she can indicate the appropriate term for change below:
Spring Summer Fall 20
(Representative Signature) (Date)
SHADEGR
SOAHOLD
SFAREGS
SGASTDN
(Term)
(Initials)
(Date)
Revised October 29, 2015
Brown Hall, Suite 307
Degree Works
Catalog Term: