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 dierent 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 oce 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
calculation.
2.5 or higher grade veried: _________________________________________________________________ Date:______________
Academic Dean Signature
You must save this file to your computer before entering your information. Do not complete form while on your Internet browser. Save file, type
in information, save again on your computer and then email the form.
