CHANGE OF MAJOR
Name
*
Last, First, MI
Date of Birth
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Student ID
*
Phone
*
Format: (000) 000-0000.
Email
*
example@example.com
Previous Degree
*
A.A.
A.S.
B.A.
B.S.
M.A.
M.Ed.
M.S.
Ed.D.
Ph.D.
Previous Major
*
New Degree
*
A.A.
A.S.
B.A.
B.S.
M.A.
M.Ed.
M.S.
Ed.D.
Ph.D.
New Major
*
Student’s Signature
*
Date
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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