Petition for Change of Degree Program

Student's Name                                                                         Student ID:___________Date            ______

Degree Program                       Year in Program                      Proposed Degree Program                  

I hereby request permission to:                                                                                                            

The reasons are:                                                                                                                                  

Date Submitted:                                                                        Signature:                                                        

Approvals Needed:                Yes      No     Comments

            (Advisor)

Dean of the Community                                                                                                                              

Director, MA Program                                                                                                                     

Director of Field Education                                                                                                              

Dean                                                                                                                                                

Comment by Registrar                                                                                                                        

Copies to:                                                                    by                                date                             

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