Pitzer College Office of the Registrar
SPECIAL MAJOR DECLARATION FORM
For students entering Fall 2016 and after
Name ____________________________________ ID# ______________________ Expected Grad Date _______________
Contact Phone Number _____________________________ Contact E-mail_______________________________________
Special Major Field(s) _______________________________Special Major Title____________________________________
ATTACH SPECIAL MAJOR PROPOSAL TO THIS FORM.
C) BREADTH OF KNOWLEDGE
(Students may not count the same course toward meeting
more than one breadth of knowledge area.)
a) Humanities/Fine Arts
1) _____________ ________________________
2) _____________ ________________________
b) Social/Behavioral Science
1) _____________ ________________________
2) _____________ ________________________
c) Natural Science
_____________ ________________________
PLEASE LIST COURSE NUMBER AND TITLE. CHECK BOX NEXT TO COURSES ALREADY COMPLETED.
d) Quantitative Reasoning
_____________ ________________________
D) WRITTEN EXPRESSION – Check One Line
____ First-Year Seminar – Course Number and Title:
_____________ _________________________
____ Writing Intensive Course - Course Number and Title:
_____________ _________________________
E) MAJOR COURSES – List Course Number & Title
Course # Course Title
1) ______________ _________________________
2) ______________ _________________________
3) ______________ _________________________
4) ______________ _________________________
5) ______________ _________________________
6) ______________ _________________________
7) ______________ _________________________
8) ______________ _________________________
9) ______________ _________________________
10) ______________ _________________________
11) ______________ _________________________
12) ______________ _________________________
CAPSTONE _________________________________
S:\forms\Major Form 2016.doc
**ADVISORS: By signing this form you confirm you are part of the appropriate field group and that you will act as the student’s major advisor.
**STUDENTS: Special majors require at least two advisors, one of which must be a Pitzer Advisor.
__________________ ___________________ _______ ______ __________________ ___________________ ________ ______
Major Advisor 1 Print Name College Date Major Advisor 2 Print Name College Date
Signature Signature
__________________ ________________ ______ _____ __________________ ________________ ________ ______
Student’s Signature Print Name College Date Additional Advisor’s Print Name College Date
Signature
A) INTERCULTURAL UNDERSTANDING
Local – Program or Course Number and Title:
_____________ _________________________
Global – Program or Course Number and Title:
_____________ _________________________
B) SOCIAL RESPONSIBILITY / JUSTICE
Justice Theory – Course Number and Title:
_____________ _________________________
Responsibility Praxis – Course Number and Title:
_____________ _________________________
