UNIVERSITY OF SOUTHERN MAINE

                           DECLARATION AND/OR CHANGE OF MINOR

          Complete this form and obtain the required signatures. Return it to the Registrar’s Office on the Gorham campus or the Enrollment Services Office on the Portland campus.

WITH THIS FORM I AM:

❒ DECLARING A MINOR            ❒ ADDING A SECOND MINOR              ❒ DROPPING A MINOR(S)

1.       STUDENT’S NAME (Please print)                     2.       I.D. NUMBER

                                                                                                                                                                 

3.       CURRENT MAJOR                                            4.       EFFECTIVE DATE

                                                                                                 ❒         FALL

                                                                                                 ❒         SPRING
                                                                                                                              

                                                                                                 ❒         SUMMER

5.       NEW MINOR 

Signature of Current Advisor                             Signature of New Department Chair