Undergraduate Degree Plan Acknowledgement and Responsibility Form
Date:
Using Veteran Benefits?
Yes
No
University ID#:
Student Athlete?
Yes
No
Student: Academic Advisor:
Catalog Year:
Previous Catalog Year (if applicable):
College of:
Degree:
Major Field of Study:
Concentration (if any):
Minor (1
st
if any):
Minor (2
nd
if any):
Course exceptions must be approved with a Course Exception Form.
Any additions or deletions must be approved with a new Degree Plan Acknowledgement Form.
The below signatures certify the above student filed a degree plan on the date under the catalog term and has received a
printed copy of the degree requirements. In order to be eligible for graduation, the student understands it is his/her
responsibility to fulfill these and other requirements in the catalog.
_______________________________
_______
Student
_______________________________
_______
Academic Advisor
Department Head
Rev. 07/17
Return to the Office of the Registrar
Box T-0620 / Stephenville, TX 76402 / 254.968.9121
254.968.9389 Fax / registrar@tarleton.edu
Check the appropriate box:
Initial Degree Plan
Revised Degree Plan
Second Major Degree Plan
Registrar Use
Processed by:
Initials
Date
Applied to Graduate?
Yes
No
______________________________________
