233 Glenbrook Road, U-4077 Storrs, CT 06269-4077 Phone: 860-486-3331 Fax: 860-486-0062 Email: [email protected]

OFFICE OF THE REGISTRAR

Additional Degree Petition Form (For students who want to pursue a second degree)

Student Instructions 1. 2. 3. 4.

Complete Parts I and II. Take this petition to the major department from which you would like the additional degree to be assigned an advisor. Take the form to both deans or deans’ designees for signatures for your Current Degree and Additional Degree. Return completed form to the Registrar’s Office at your current campus.

Part I Name: Last Student ID (if known):

First

Middle Initial

and/or NetID (if known):

Cell Phone: Email address: Student Signature:

Part II I wish to pursue the following degree programs:

Current Degree School/College: Department: Major/Degree Sought: Advisor’s Name: Advisor or Departmental Signature: Current Degree Dean or Designee Signature:

Additional Degree School/College: Department: Major/Degree Sought: Advisor’s Name: Advisor or Departmental Signature: Additional Degree Dean or Designee Signature:

registrar.uconn.edu