Fillable Undergraduate Change of Major, Minor, Degree or Advisor (Central Connecticut State University)

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Undergraduate Change of Major, Minor, Degree or Advisor (Central Connecticut State University)

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Submit to:
Office of the Registrar, Willard-DiLoreto Hall, Room D202
Fax (860) 832-2250, E-mail regstaff@ccsu.edu
Central Connecticut State University
Office of the Registrar
Undergraduate Change of Major, Minor, Degree or Advisor
Note: To declare a second or double major, use the “Second Major Request” form.
Part One: Student Information
Name: ______________________________ Student ID #: _____________________________
Phone #:_____________________________ E-mail: __________________________________
Part Two: Requested Changes
Only complete the categories that are changing.
Do not use this form for a change of major to Nursing, Pre-Nursing, Special Studies or General Studies. Consult www.ccsu.edu.
Change Degree to:
Change Major to:
Change Major Concentration to:
Change Minor(s) to:
Change Advisor(s) to:
Add Undergraduate Certificate:
Part
Three: My Curriculum Summary
Summarize your complete curriculum after all requested changes.
My Degree:
My Major:
My Major Concentration (if applicable):
My Minor(s) (if applicable):
My Certificate Program (if applicable):
Part Four: Approvals (Required for categories changed in Part Two)
Chair, Major (or Certificate) Department
Date
Advisor’s name as assigned by department (Print)
Chair, First Minor Department
Date
Chair, Second Minor Department Date
Date
School of Education & Professional Studies (SEPS)
Advising Center (all SEPS programs, including teacher
education)
Part Five: Student Acknowledgement
Student Signature: _________________________________________ Date: ________________________
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Undergraduate Change of Major, Minor, Degree or Advisor (Central Connecticut State University)

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Completed 7 March 2022

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