Change of Program Request

Student Information
Name Name First Last
Student ID
WUST Email
Are you a graduate or undergraduate student?
Are you a first quarter student?
Current Program Information
Name of Program
BSIT Concentration:
BBA Concentration:
MSIT Concentration:
MBA Concentration:
New Program Information
Name of Program
BSIT Concentration:
BBA Concentration:
MSIT Concentration:
MBA Concentration:
Start Date: Start Date: / MM / DD YYYY
Please explain why you would like to change your program.
I, I, First Last
acknowledge that I am requesting to change my program of study from acknowledge that I am requesting to change my program of study from / MM / DD YYYY
to Date to Date / MM / DD YYYY

I understand that all courses may not be transferrable, and I will be responsible for meeting the degree requirements of my new program.
Student Signature:
*By signing this form you agree to follow the policies and guidelines set forth in the original Enrollment Agreement*
**Please remember that a $50 Change of Program fee will be assessed during the process**

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Today's Date: Today's Date: / MM / DD YYYY