UNDERGRADUATE CHANGE OF MATRICULATION FORM
REGISTRAR’S OFFICE
Instructions: This form is to be used by undergraduates to change a major or to add a second major, emphasis, or minor. If
adding programs, complete only the New Major/Emphasis/Minor box. The department of each major/minor/emphasis must sign
this form. If the student is changing departments, then both Department Heads must sign.
Please Print Clearly:
Student I.D. Number Name (Last, First, M.I.) E-Mail Address
Please provide the following to be updated in the university database:
Local Address Permanent Address
Street Street
City State Zip City State Zip
Phone Phone
CURRENT MAJOR NEW (OR ADDITIONAL) MAJOR/EMPHASIS/MINOR
Attention departments and colleges: If you want a copy of this form, please make a copy before you send it to the Registrar’s Office.
For Registrar’s Office Use Only:
Processed by__________________ Date_________________
Residency_____________________
Form may be mailed to Utah State University Registrar’s Office, 1600 Old Main Hill, Logan UT 84322-1600
Major____________________________________________
Department______________________ College__________
Student: Please state the reason for changing majors
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Cumulative GPA:___________ USU GPA:___________
Status (Please Circle): Warned Probation Good Standing
Signature for current major:
_________________________________________________
department signature/title
Date:______________________________
Major________________________________________
Emphasis/Option_______________________________
(an emphasis must be listed if it is required for the major)
Department_________________ College__________
Catalog Year____________________ (necessary for CAPP)
Class Rank: SR JR SO FR
Second Major? Yes No
Degree: AAS AS AA BS
BA BFA BLA BM
Accepted on: Warned Probation Good Standing
Attempted Hours ______
Accepted by Department_________________________
Printed name and title
___________________________________
Signature
Name of Advisor_______________________________
Date__________________________
Minor________________________________________
Department____________________ College________
Accepted by___________________________________
department signature
Date___________________________
Major____________________________________________
Department______________________ College__________
Student: Please state the reason for changing majors
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Cumulative GPA:___________ USU GPA:___________
Status: Warned Probation Good Standing
Signature for current major:
_________________________________________________
department signature/title
Date:______________________________
