Change of Major Form

Indicate the program/curriculum change you are making and submit the form
Fields marked with a * are required

Student ID Number:
RequiredRequired
Telephone:	E-mail:
( Required) Required - Required*
First Name:	Last Name:	MI:
* Required	* Required
Street:
* Required
City:	State:	Zip:
* Required	* Required	* Required

1. Current Program of Study - Code Title

2. New Educational Plan: Do you plan to pursue a degree or certificate at Lake Land College?

yes no (carefully read the below information)

If you checked NO, your status will be non degree seeking and you will be ineligible for Federal Title IV financial aid programs.

3. Degree / Certificate Objective:

4. New Program of Study: * Required

5. Reason for Change:

6. Certification Statement: By submitting this form I certify the foregoing information accurately reflects my educational objective while attending Lake Land College. I understand this program change could affect my eligibility for financial aid.

Help us keep spam down, please enter the 4 digit year of the current year (ex. 2012): A value is required.

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