UNIVERSITY OF ILLINOIS AT SPRINGFIELD
Office of Records and Registration
Change of Curriculum Form
(Major, Certificate, and/or Minor)
Please complete, print (see "Print Form" above), and return this form to the Office of Records and Registration, University Hall, One University
Plaza, MS UHB 1076, Springfield, IL 62703-5407. This form must be received by the posted deadline each semester; forms are processed on a
weekly basis. Please be sure to read all information below prior to completing the curriculum portion of the document.
This form does not imply admission to any program which has additional application procedures in addition to University admission.
GRADUATE STUDENTS: Students who are making a curriculum change by adding a certificate or changing the delivery mode of their major
(on-campus to online) must submit a Change of Curriculum Form. Students who wish to apply to a new major program (on-campus or online)
must submit a new application. The Change of Curriculum Form or application submitted will initiate consideration by the newly chosen
program.**
NON-DEGREE STUDENTS: If you are currently a non-degree seeking student and would like to be a degree seeking student, you must
submit a new application for admission.**
Last Name First Name
UIN
UIS Email* Daytime Phone
Current Curriculum Information New Curriculum Information
Major or Certificate 1
Minor 1 Minor 1
Minor 2
Major or Certificate 2
Minor 2
Major or Certificate 2
Telephone (217) 206-6174 Fax (217) 206-6620 Toll-free (888) 977-4847 Email registrar@uis.edu
**For assistance with the admission process, please contact Applications / Evaluations by calling (217) 206-6174 or by e-mailing registrar@uis.
edu.
Student Signature
UNDERGRADUATE STUDENTS: Students who are making a curriculum change (adding a minor, etc.) must submit a Change of
Curriculum Form. Students wishing to change to an online program or who wish to add elementary or secondary education will have their
information submitted to the appropriate program for review and an admission decision.**
Effective Semester Effective Year
Please note: All requests received after the posted deadline will
be effective the following semester.
3-03-2020
*You MUST enter your
official UIS Email address
Copies:
Original (Permanent File)
Program Office(s)
Notification (sent via official UIS Email by Office of Records and Registration):
Student
For Office Use Only
Processed By: _____________
Date: _____________
Major or Certificate 1
