Change of Curriculum
QPA Adjustment Form
This form is used to indicate courses on a student’s transcript which are not to be included in computing the cumulative Q.P.A. This form
should only be used for students who have changed their major and are requesting a grade adjustment for coursework taken in the previous
major which is no longer relevant to current program requirements. A student may have this rule applied to only one change of curriculum
which occurs within the first 36 credit hours attempted at the college.
Name: __________________________________________________________________________ SUNY Erie ID# ____________
Previous Academic Program: _______________________________________________________ Date: ____________________
New Academic Program: __________________________________________________________ Semester: ________________
Course Number
Credit Hours
Semester Course was taken
Student Signature:_____________________________________________________________________
Requestor signature: ___________________________________________________________________
If dierent from Department Chair (ie. Counselor or Adviser)
Department Chair Signature:_____________________________________________________________
Approval needed from new academic program Department Chair
Form is sent to Academic Dean’s oce upon Completion.The Academic Review Committee will review following nal grades for
the current term. If a semester GPA of 2.5 is reached, the grades for the courses listed above will be removed from the GPA
2.5 or higher grade veried: _________________________________________________________________ Date:______________
Academic Dean Signature
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in information, save again on your computer and then email the form.