Student Change of Status Form
Student Name: __________________________ ID Number: __________________________
Current GPA: ___________________________ Phone Number: _______________________
Position
Signature
Date
Approved
Denied
Advisor
Department Chair
Dean
(only required at the request of the Registrar
for special circumstances)
Vice President for Academic Affairs
(only required at the request of the Registrar
for special circumstances)
Change Minor(s)- Requires signature of Advisor
Addition of a minor
Name of Minor:
Removal of a minor
Name of Minor:
Change of Primary Major- Requires signature of Advisor AND Department Chair of proposed major
Current Major: ______________________________
Proposed Major: ____________________________________
Advisement Track (if applicable): _______________________
Effective Date: ______________________________________
Other Action(s)- Requires signature of Advisor AND Department Chair. Deans signature may be requested.
Permission for part-time matriculated student to change
to full-time status
Semester to begin Full-time:
Unspecified Other Action: