Student Change of Program or Major
This publication was created by the CCAC Public Relations & Marketing Department. Change of Program or Major-POD-SLK-AUG15
Name _________________________________________________ Student ID ___________________________
I am changing my academic program or major:
From (present program or major) ______________________________________________ Code # _____________
To (new program or major) ___________________________________________________ Code # _____________
_______________________________________________________________________ Code # _____________
The new program or major takes effect: Semester _________________________________ Year _______________
(Check with an academic advisor to determine how your coursework ts into the new program); program changes made after the end of the
drop/add period will be effective for the next term.
Student signature __________________________________________________________ Date _______________
College signature __________________________________________________________ Date ______________
For restricted enrollment programs (i.e., health career programs), this form must be approved by a department representative.
Enrollment Department signature ______________________________________________ Date ______________
Transfer Students:
To which college or university do you plan to transfer?
School ____________________________________________________
Program ___________________________________________________
FERPA Statement: Under the Family Educational Rights and Privacy Act (FERPA) or 1974, and as amended, I understand that my educational
records cannot be released without my written permission. I therefore authorize the release of my education records between the school
named above and the Community College of Allegheny County (CCAC) in order to share educational records between the two institutions
without violation of FERPA. I understand that this release agreement will be in effect as long as I have declared this intention to transfer.
I have the right to rescind this release agreement and end this potential program on my CCAC record.
My signature below is my agreement that CCAC and the school named above may share my educational record to best assist me in planning
for a successful transfer.
Student Signature _________________________________________________________ Date ______________
Allegheny Campus Boyce Campus North Campus South Campus
Academic Advisement Academic Advisement Academic Advisement Academic Advisement
808 Ridge Avenue 595 Beatty Road 8701 Perry Highway 1750 Clairton Road
Pittsburgh, PA 15212 Monroeville, PA 15146 Pittsburgh, PA 15237 West Mifflin, PA 15122
412.237.2744 724.325.6739 412.369.3740 412.469.6238
OFFICE USE ONLY: Entered by______________________________________________________________________________ Date __________________________________
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