Microsoft Word - Program Change Form Fall 2020 Update.docx

PROGRAM CHANGE FORM

FOR ENROLLED TC STUDENTS

This application is for current Teachers College students that wish to change from their current degree program to an equivalent or lesser

concentration and/or degree at the College. All fields must be completed. Please type or print in black ink.

THIS PAGE TO BE COMPLETED BY STUDENT

APPLICANT INFORMATION:

TC ID Number: T_______________________ or UNI: _______________________

Name: ______________________________________________________________________________________

Last/Family Name First/Given Name Middle Name

Birthdate (MM/DD/YYYY): ______________________________ E-mail: All correspondence will be sent to student’s TC email address.

CURRENT PROGRAM OF STUDY:

Current Department: ______________________________________ Major Code: _____________Major Code (and certification if applicable e.g. INIT,

DUAL etc.) are next to program name in parentheses in degree audit profile

Current Program and Degree: _________________________________________________________________________________________

Are you currently in a teacher certification program? ☐ Yes ☐ No

Are you applying to a teacher certification program? ☐ Yes ☐ No

Do you plan to complete the program/degree from which you are transferring? ☐ Yes – When: _________________ ☐ No

NEW PROGRAM OF STUDY:

Desired Department: __________________________________________ Major Code: ________________ (If known)

Desired Program (and certification if applicable e.g. INIT, DUAL etc.): __________________________________________________________________

For which degree are you applying? [check one]

☐ Master of Arts ☐ Master of Science ☐ Master of Education ☐ Doctor of Philosophy

☐ Doctor of Education in the College of Teaching an Academic Subject ☐ Doctor of Education

For which term are you applying? [insert year] ☐ Spring 20____ ☐ Summer 20____ ☐ Fall 20____

What is your expected graduation date from this program? [insert year] ☐ Oct 20____ ☐ Feb 20____ ☐ May 20____

Please provide a brief explanation for this request to change programs:

_____________________________________________________________________________

I attest that the information provided in this application is true.

Signature: ________________________________________ Date: _____________________

Teachers College, Columbia University ● Office of the Registrar ● registrar@tc.columbia.edu ● (212) 678-4050

THIS PAGE FOR OFFICIAL USE ONLY

NOTE TO PROGRAM DIRECTORS:

This currently enrolled TC student seeks admission to a different certification, degree and/or program as indicated in the New Program of Study

section of this Program Change Form.

Recommendations, transcripts and other application requirements are not provided or required with the Program Change Form. If you require

application materials, the student must complete and submit a new online degree application. Do not confirm your approval below if you require a

formal application review.

Your approval below recommends this student to the new program without formal application review. Only applications signed by the

appropriate program director will be eligible for review and processing by the Office of the Registrar.

The Office of Registrar will notify the student when the Program Change Form has been processed.

TC ACADEMIC PROGRAM DIRECTOR:

☐ I approve the above Program Change.

Print Name: _____________________________________________

Signature: ________________________________________ Date: _____________________

If you are unable to sign this form physically or electronically, you may send an email directly to registrar@tc.columbia.edu confirming your approval.

OFFICE OF THE REGISTRAR:

Degree: MA MS ME DE DC DP CE

Decision: AF AD AP AX RJ Need Re-App OT_____

Initial: ____________ Date: ____________

HANDLE APPLICATIONS WITH EXTREME CARE

Application materials are sensitive and confidential documents and may be irreplaceable. Original materials and/or copies may not leave the

college. These materials and all copies must be treated in a confidential manner to protect the privacy of the information contained therein. At the

time a person is enrolled, these materials and all copies are education records and are subject to the provisions of the federal Family Education

Rights and Privacy Act (FERPA).

Teachers College, Columbia University ● Office of the Registrar ● registrar@tc.columbia.edu ● (212) 678-4050