Form Go-19 - Request For Change Of Program

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REQUEST FOR CHANGE OF PROGRAM
Currently admitted graduate students in good academic standing who wish to 1) transfer to a different degree or graduate certificate
program, 2) add admission to another degree or graduate certificate program, or 3) add admission to an education endorsement must
file this form with their current department. The student is responsible for submitting complete departmental application materials to
the proposed new department as needed. A student must have current term registration for a GO-19 form to be processed by the Office
of Graduate Studies.
If adding a program, please note:
Graduate courses can be applied to two master’s degrees only under the dual degree option; see the PSU Bulletin and the GO-14
form for details.
Graduate courses cannot be applied to two graduate certificates.
Graduate courses can be applied to a master’s degree and a doctoral degree provided the master's degree is awarded prior to or
concurrent with the doctoral degree.
See the PSU Bulletin for additional information about sharing coursework between programs.
A change to a student’s admission status may impact tuition assessment.
Name _______________________________________________________________ PSU ID# _____________________________
PSU E-mail (print clearly)_______________________________________________ Daytime phone _________________________
Student is currently admitted for the following program: _________________________ in _________________________________
(degree/grad cert)
(major name)
CHECK ONLY ONE OPTION BELOW:
I wish to transfer from my present program to the _________________________ in ___________________________________
(degree/grad cert)
(major name)
I understand this action will cancel admission to my current program.
I wish to add to my present program the _________________________ in ____________________________________________
(degree/grad cert)
(major name)
I wish to add to my present program the Standard/Continuing Licensure in ____________________________________________
(endorsement)
Student's signature _______________________________________________________ Date _______________________________
Approved by ____________________________________________________________ Date _______________________________
Department Chair or Graduate Committee Chair of student’s current program
REQUIRED – The new department/program approves the admission change requested above.
Signed _________________________________________________________________ Date ______________________________
Department Chair or Graduate Committee Chair of student’s new program
Processed by Office of Graduate Studies _______________________________________Date ______________________________
11/15 OGS
GO-19
This form is available on the OGS website:

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