OFFICIAL REQUEST FOR CHANGE IN ACADEMIC SCHEDULE
(For the Academic Schedule Only)
ALL INFORMATION, INCLUDING INSTRUCTOR'S SOCIAL SECUR
ITY NUMBER IS NEEDED BEFORE A CHANGE CAN BE PROCESSED.
Indicate Semester: 1Winter 1Spring 1Summer I 1Summer II 1Summer III 1Fall
Year
INSTRUCTOR'S CHANGE (Only) COURSE CHANGES (Only)
Add Instructor's
Name
Change Instructor's
Name
Social Security
Number (Must
be included)
Course Prefix and
Number (Indicate
course here)
Change
Day/Time
From
Change
Day/Time
To
Seats
(Indicate
Number)
Add Delete
Add Section
(Indicate
section
number only)
Delete Section
(Indicate
section
number only)
Approved:
Department Chair/Director Date Dean Date
Entered in Computer Database by:
Date:
6.5.09
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