7/2020 GO-19
REQUEST FOR CHANGE OF PROGRAM (GO-19)
Currently admitted graduate students in good academic standing who wish to 1) transfer to a different degree or
graduate certificate program, 2) add admission to another degree or graduate certificate program, or 3) add admission
to an education endorsement must submit this form to the proposed new program for approval. The student is
responsible for submitting complete departmental application materials as needed. A student must have current term
registration for a GO-19 form to be processed by the Graduate School.
If adding a program, please note:
• Graduate courses can be applied to two master’s degrees only under the Dual Degree allowance; see the PSU
Bulletin and the GO-14 form for details
• Graduate courses can be applied to a master’s degree and a doctoral degree provided the master's degree is
awarded prior to or concurrent with the doctoral degree
See the PSU Bulletin for additional information about sharing coursework between programs.
A change to a student’s admission status may impact tuition assessment.
Name _______________________________________________________________ PSU ID# _______________________________
PSU email (print clearly)_______________________________________________ Daytime phone ___________________________
I am currently admitted for the following program: ____________________________ in ___________________________________
(degree/grad cert) (major name)
CHECK
ONLY ONE OPTION BELOW:
□ I wish to transfer from my present program to the _________________________ in _____________________________________
I understand this action will cancel admission to my current program. (degree/grad cert) (major name)
□ I wish to add to my present program the _________________________ in _____________________________________________
(degree/grad cert) (major name)
□ I wish to add to my present program the Education Licensure or Endorsement in ________________________________________
(endorsement)
Student's signature _______________________________________________________ Date _______________________________
REQUIRED – The new department/program approves the admission change requested above.
Approved by ____________________________________________________________ Date ______________________________
Department Chair or Graduate Program Director of student’s new program
Processed by the Graduate School ____________________________________________Date ______________________________
