As set forth in full in the Student Handbook/Course Catalog, Southern Crescent Technical College is an Equal
Opportunity Institution and does not discriminate on the basis of race, color, national origin, sex, age or disability.
Revision Date: 09/01/2018
PROGRAM CHANGE REQUEST
Student Information
Name
: Student ID:
Phone Number
E-mail:
Term
Eff
ective:
Stud
ent
Sign
at
u
re:
D
ate:
List CUR
REN
T
Program:
Current Award Level: (Select One) Certificate Diploma Degree
List
NE
W
Program:
New Award Level: (Select One) Certificate Diploma Degree
Type of Change: (Select One)
Change to NEW program
Change to DUAL program (CURRENT + NEW)
Note: For Change Type DUAL, the NEW program must be the same Award Level as CURRENT program.
Financial Aid / V.A. Coordinator Signature
Please Be Advised:
• Students receiving financial aid require a signature from Financial Aid
• Students receiving Veteran’s benefits require a signature from the V.A. Coordinator
Finan
c
ial Aid Signa
t
u
re
:
V.A. Coordin
at
o
r
Sign
at
u
re
:
Admissions Use Only
STATUS: Regular Provisional Special Admit
Evalu
ate
d b
y
: D
ate:
En
tere
d b
y
: D
ate
:
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
