Fillable Return this completed form to the Registrars Office/ (Asnuntuck Community College)

Fill Online, Printable, Fillable, Blank Return this completed form to the Registrars Office/ (Asnuntuck Community College) Form

Use Fill to complete blank online ASNUNTUCK COMMUNITY COLLEGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Return this completed form to the Registrars Office/ (Asnuntuck Community College)

On average this form takes 13 minutes to complete

The Return this completed form to the Registrars Office/ (Asnuntuck Community College) form is 1 page long and contains:

  • 0 signatures
  • 20 check-boxes
  • 42 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Asnuntuck Community College

BROWSE ASNUNTUCK COMMUNITY COLLEGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Return this completed form to the Registrar’s Office/ AS-Registrar@Asnuntuck.edu
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 Registrar’s 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)
□ DECLARE A PRIMARY MAJOR:
Name of Major:: _______________________________________________________ Code:______________
□ DECLARE A SECONDARY MAJOR:
Name of Major:: _______________________________________________________ Code:______________
□ CHANGE MY PRIMARY MAJOR:
Current Primary Major: ______________________________________
New Primary Major: ________________________________________ Code:______________
□ CHANGE MY SECONDARY MAJOR:
Current Secondary Major: ___________________________________
New Secondary Major: _____________________________________ Code:______________
Student’s Signature: __________________________________________ Date: ______________________
FOR OFFICE USE ONLY
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,
yzelinka@asnuntuck.edu (860) 253-3092 and Deborah Kosior, 504/ADA
Coordinator, AS-DisabilityServices@asnuntuck.edu (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, yzelinka@asnuntuck.edu
(860) 253-
3092 and Deborah Kosior 504/ADA Coordinator, AS-DisabilityServices@asnuntuck.edu (860) 253-3005, Asnuntuck Community
College, 170 Elm Street, Enfield, CT 06082.07/15
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Return this completed form to the Registrars Office (Asnuntuck Community College)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 3 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document