Plan Modification Or Internal/faculty Transfer Application Form
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1
2OFFICE OF THE REGISTRAR
Plan Modification or
Waterloo, Ontario, Canada N2L 3G1
519-888-4567, ext. 35378 | fax 519-746-2882 | uwaterloo.ca/registrar
Internal/Faculty Transfer
Application
Instructions
1.
Ensure the form is signed by the appropriate academic advisor/department if applicable.
2.
Attach a résumé of your work experience if you are applying for a Co-op Plan and were not previously registered in Co-op.
3.
Make a copy for your records and submit the original form and résumé (if applicable) to the Office of the Registrar.
Note: Normal processing time is 2 weeks, but may be subject to a review of your academic performance in the current term.
Please select one as appropriate:
Plan Modification
Internal/Faculty transfer
Waterloo student identification number ________________________________________
Last name ________________________________ First name ____________________________ Middle name(s) _____________________________
UWaterloo email address _______________________________________ Birth date ______________________ Phone ________________________
Requested academic information – Include all majors, minors, options, and specializations under current and requested academic plans.
Current academic plan _____________________________________________________________________________________________________
Academic program
Honours
4-Year General
3-Year General
Non-degree/Post-degree
Form of study
Regular
Co-op
Online
Campus
University of Waterloo
St. Jerome’s University
Renison University College
Requested academic plan __________________________________________________________________________________________________
Academic program
Honours
4-Year General
3-Year General
Non-degree/Post-degree
Form of study
Regular
Co-op
Online
Campus
University of Waterloo
St. Jerome’s University
Renison University College
Start term
Fall
Winter
Spring
Year ________
Reason for Request
– Indicate your academic interests in the requested plan and explain the reasons for changing your plan. Attach additional pages as necessary.
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Student signature _______________________________________________________ Date ______________________________________________
For office use only
Clear Form
Plan modification approvals
Admit
Refuse
Indicate the Undergraduate Calendar regulations to be followed for the requested plan modification above.
Academic program calendar year (e.g., 2015-2016) ____________________ Academic plan calendar year (e.g., 2015-2016) _____________________
Options/minors/specializations calendar year (e.g., 2015-2016) ____________________
Comments ________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Name _____________________ Department __________________ Signature _________________________ Ext. __________ Date ______________
Name _____________________ Department __________________ Signature _________________________ Ext. __________ Date ______________
Co-operative Education and Career Action Approval (if applicable)
Name_________________________________ Signature _____________________________________ Ext. _____________ Date _______________
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