Change of Major Teacher Request
Students should be aware that a request to change applied teachers is an important decision that affects
all parties involved. Applicable faculty and the Chairperson of the Department of Music will consider your
request carefully and consult all parties before any action is taken. Please note that an applied faculty
member is also able to request that such changes be implemented. In either case, this form must be
completed.
Name of Student ______________________________________________________________________
Student’s Signature ____________________________________________________________________
Date of Request _______________________________________________________________________
Major Instrument _____________________________________________________________________
Present Applied Teacher ________________________________________________________________
Suggested New Teacher ________________________________________________________________
Proposed Date of Change (circle one) Fall Term Spring Term Other _____________
Please state the reason(s) for your request and indicate if you have discussed the matter with: (1)
your present teacher, proposed teacher, or division coordinator OR (2) the Division Coordinator
and proposed new teacher.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Recommendation of Current Applied Teacher:
_______Accept _______Reject _________________________________________ (signature)
Recommendation of Division Coordinator:
_______Accept _______Reject _________________________________________ (signature)
Decision of Department Chairperson:
_______Accept _______Reject _________________________________________ (signature)
Forwarded to Assistant to the Chairperson for Implementation __________________________ (date)
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