Honors College Change Of Status Form printable pdf download

Honors College Change Of Status Form

Honors College

Change of Status Form

Please note: If you withdraw after the first class day, you will pay fees for that semester and be eligible to receive Honors

College services. If you withdraw prior to the first class day, you are eligible for a refund of Honors College fees for the

semester.

Please Complete All Information

Name:

PeopleSoft ID:

Address:

Date:

Email:

Cell:

Type of Status Change:

Reinstatement

Hiatus

Duration of Hiatus:

Withdrawal

Reason:

Contact Info

(if not person above) Name:

Email: _________________________ Phone:

*If any of your contact information has changed, please fill out a Change of Information Form, which can be found at

under “Current Students,” or in the Student Services Office.*

For Office Use Only

Brenda Rhoden, Assistant Dean, Student Affairs

Date

Andy Little, Coordinator, Academic Services

Date

Franco Martinez, Academic Advisor

Date

Larry Lyke, Academic Advisor

Paper File

Database

Priority List

List-serv

Electronic File

Honors College Change Of Status Form