Revised 9/2020
REQUEST TO CHANGE/ADD SECOND MINOR
Student’s Name ____________________________________
Student ID# ______________
Email _____________________________________________
Phone __________________
Current Minor ________________________________________________________________
Required Signatures:
Advisor _______________________________________
Date ____________________
Department Chair _______________________________
Date ____________________
Dean/Director __________________________________
Date ____________________
New/Second Minor (please circle new or “second”) ________________________________
Required Signatures:
Advisor _______________________________________
Date ____________________
Department Chair _______________________________
Date ____________________
Dean/Director __________________________________
Date ____________________
Student’s Signature ______________________________
Date ____________________
Registrar’s Office ________________________________
Date ____________________