Office of the Registrar 330 Powell Avenue, Newburgh, New York 12550 • www.msmc.edu

Ph: 845-569-3281 Fax: 845-569-3301

Change/Declare Major, Minor, Concentration, or Certification Complete this form and bring to the major division that you are leaving and to the major division that you are changing to. After it is signed by the division chairperson(s), return to the Registrar’s Office. Changes in Minor do not require divisional approval. Student Name: ________________________________________________ ID #: ______________ Student’s Signature: ______________________________________ Date: ___________________

Changing Major Major to Delete: __________________________________________________________________ Division Chairperson (signature required): _______________________ Date: __________ New Major: ______________________________________________________________________ Concentration (if applicable): ___________________________________________________ Division Chairperson (signature required): _______________________ Date: __________

Adding 2nd Major 2nd Major ________________________________________________________________________ Concentration (if applicable): ____________________________________________________ Division Chairperson (signature required): _______________________ Date: __________

Adding/Deleting Minor Adding Minor ____________________________________________________________________ Deleting Minor____________________________________________________________________

Adding/Changing/Deleting Certification New Ed Certification:______________________________________________________________ Deleting Ed Certification: __________________________________________________________ Changing Education Certification: __________________________________________________ Division Chairperson (signature required): _______________________Date___________ Office Use Only:

Processed: _____________ Date: _______