Return this completed form to the Registrars Office/
In order to process your request, your high school transcripts or a copy of your original high school diploma must
have been submitted and processed by the Office of Admissions.
After this form has been processed by the Registrars Office, your degree/certificate will be updated in Banner/myCommNet.
Some students may have a change in advisor.
Contact your advisor for details about your new program plan. You should also review a new Degree Works audit.
Last Name: First Name:_________________________ Middle:________________
Banner ID #: Email: Phone:_________________________
I am seeking to: (See reverse side for a complete listing of degree/certificate programs and codes)
Name of Major:: _______________________________________________________ Code:______________
Name of Major:: _______________________________________________________ Code:______________
Current Primary Major: ______________________________________
New Primary Major: ________________________________________ Code:______________
Current Secondary Major: ___________________________________
New Secondary Major: _____________________________________ Code:______________
Student’s Signature: __________________________________________ Date: ______________________
High School Transcript
: □ Yes □ No Verified by: ___________________________ Date: ______________
Immunizations or Waiver: □ Yes □ No Verified by: ___________________________ Date: ______________
Program Change: □ Yes □ No Verified by: ___________________________ Date: ______________
Re-evaluate Transcript: □ Yes □ No Verified by: ___________________________ Date: ______________
Course Subs on DW: □ Yes □ No Verified by: ___________________________ Date: ______________
Academic Affairs Advisor Change: □ Yes □ No Verified by: ____________________ Date: ______________
Declaration or Change of Major Form
Associate Degree Programs Program Code
Accounting M11MA03
Business Administration (AS) M11MA67
Communications M11MA10
Communications: Broadcasting M11MA11
Communications: Journalism M11MA12
Criminal Justice M11MA29
Early Childhood Education (AS) M11MA89
Engineering Science M11MA41
General Studies M11MA47
Human Services M11MA49
Liberal Arts M12MA18
Liberal Arts: Fine Arts M12MA51
Massage Therapy M11MA19
Registered Medical Assistant (AS) M11MA37
Technology Studies M11MF11
Tech Studies: Machine Technology M11MA90
Tech Studies: Electronics Technology M11MA16
Tech Studies: Electro-Mechanical
Maintenance M11MF14
Tech Studies: Welding Technology M11MA97
Certificate Programs Program Code
Accounting Assistant M13MJ22
Business Administration Certificate M13MJ42
Certified Admin. Medical Office Skills M13MK66
Certified Phlebotomy Technician M13MK62
Early Childhood Education Certificate M13MJ81
Entrepreneur Certificate M13MJ86
Gerontology Certificate M13MJ26
Health Career Pathways Certificate M13MK55
Health Information Mgmt. Technician M13MK64
Human Services Management Cert. M13MJ11
Marketing Certificate M13MJ25
Office User Specialist M13MJ14
Registered Medical Assistant Cert. M13MJ92
Web Designer Certificate M13MJ68
UPDATED: April 2020
Manufacturing Technology Certificates:
Program Code
Adv. Mfg. Machine Technology M13MK60
Advanced Welding M13MJ59
Electronics Technology Certificate M13MJ39
Electro-Mechanical Maintenance Cert. M13MJ91
Connecticut State Colleges and Universities (CSCU)
Transfer Ticket Degrees:
Program Code
CSCU Transfer: Art Studies M12MG21
CSCU Transfer: Biochemistry Studies M12MG23
CSCU Transfer: Biology Studies M12MG01
CSCU Transfer: Business Studies M12MG12
CSCU Transfer: Chemistry Studies M12MG02
CSCU Transfer: Communication Studies M12MG03
CSCU Transfer: Criminology Studies M12MG04
CSCU Transfer: Early Child. TC Studies M11MG14
CSCU Transfer: English Studies M12MG05
CSCU Transfer: History Studies M12MG06
CSCU Transfer: Math Studies M12MG07
CSCU Transfer: Physics Studies M12MG19
CSCU Transfer: Political Science Studies M12MG08
CSCU Transfer: Psychology Studies M12MG09
CSCU Transfer: Social Work Studies M12MG10
CSCU Transfer: Sociology Studies M12MG11
CSCU Transfer: Spanish Studies M12MG20
Notice of Non-discrimination: Asnuntuck Community College does not discriminate on the basis of race, color, religious creed, age, sex,
national origin, marital status, ancestry, present or past history of mental disorder, learning disability or physical disability, sexual orientation,
gender identity and expression or genetic information in its programs and activities. In addition, the College does not discriminate in
employment on the basis of veteran status or criminal record. The following individuals have been designated to handle inquiries regarding the
non-discrimination policies: Yhara Zelinka, Title IX Coordinator, (860) 253-3092 and Deborah Kosior, 504/ADA
Coordinator, (860) 253-3005, Asnuntuck Community College, 170 Elm Street, Enfield, CT 06082.
Políticas Antidiscriminatorias: Asnuntuck Community College no discrimina por razones de raza, color, creencias religiosas, edad, género,
nacionalidad, estado civil, ascendencia, historia presente o pasada de discapacidad mental o física, problemas de aprendizaje, orientación
sexual, Identidad y expresión de género, o información genética, en sus programas o actividades. Adicionalmente Asnuntuck no discrimina
individuos por razones pertinentes a la categoría de veteranos o historia criminal. Las siguientes personas han sido designadas para resolver
cualquier inquietud pertinente a las políticas antidiscriminatorias: Yhara Zelinka, Title IX Coordinator,
(860) 253-
3092 and Deborah Kosior 504/ADA Coordinator, (860) 253-3005, Asnuntuck Community
College, 170 Elm Street, Enfield, CT 06082.07/15